Provider Demographics
NPI:1073060323
Name:WILCOX, PAIGE NICHOLE (RN)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:NICHOLE
Last Name:WILCOX
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1281 CRANWOOD SQ N
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-1340
Mailing Address - Country:US
Mailing Address - Phone:937-707-4327
Mailing Address - Fax:
Practice Address - Street 1:1281 CRANWOOD SQ N
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-1340
Practice Address - Country:US
Practice Address - Phone:937-707-4327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-03
Last Update Date:2016-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.413720163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse