| NPI | 1194599894 |
|---|---|
| Former Name | CORRIE LYNN WILCOX |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NE 115092) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ID 78033) |
| Enumeration Date | 2023-11-13 |
| Last Update Date | 2023-11-29 |