Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | F341535-1 | NY |
NPI | 1003356668 |
---|---|
Provider Name | Nancy Lm Wilcox |
First Address | Rochester, NY 14621-3065 |
Second Address | Rochester, NY 14621-3065 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2017 |
Last Update Date | 30/04/2021 |