Provider Demographics
NPI:1326677121
Name:PRICE, WILMARA (DNP, CRNA, APRN)
Entity Type:Individual
Prefix:DR
First Name:WILMARA
Middle Name:
Last Name:PRICE
Suffix:
Gender:F
Credentials:DNP, CRNA, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19253 SW 5TH ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-5418
Mailing Address - Country:US
Mailing Address - Phone:954-806-8959
Mailing Address - Fax:
Practice Address - Street 1:19253 SW 5TH ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029-5418
Practice Address - Country:US
Practice Address - Phone:954-806-8959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-03
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9300006163W00000X
FL11019638367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse