Provider Demographics
NPI:1568404994
Name:WILGUS, BARBARA ELAINE (MSN, CRNP)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:ELAINE
Last Name:WILGUS
Suffix:
Gender:F
Credentials:MSN, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3210 GLENMORE AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21214-1815
Mailing Address - Country:US
Mailing Address - Phone:410-396-9410
Mailing Address - Fax:410-396-9437
Practice Address - Street 1:600 N WOLFE ST, CARNEGIE 346
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0005
Practice Address - Country:US
Practice Address - Phone:410-955-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR133997363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD302603500Medicaid
MDP34261Medicare UPIN
MD302603500Medicaid