Provider Demographics
NPI:1457303315
Name:WILCOX, TRISHA L (APNP)
Entity Type:Individual
Prefix:MS
First Name:TRISHA
Middle Name:L
Last Name:WILCOX
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9200 W WISCONSIN AVE
Mailing Address - Street 2:CARDIOTHORACIC SURGERY
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3522
Mailing Address - Country:US
Mailing Address - Phone:414-955-6900
Mailing Address - Fax:414-955-6204
Practice Address - Street 1:9200 W WISCONSIN AVE
Practice Address - Street 2:CARDIOTHORACIC SURGERY
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3522
Practice Address - Country:US
Practice Address - Phone:414-955-6900
Practice Address - Fax:414-955-6204
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2607363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
001856578XOtherHUMANA
WI1457303315Medicaid
Q48790Medicare UPIN
001856578XOtherHUMANA
WI68086 1065Medicare PIN