Provider Demographics
NPI:1649379397
Name:WHEELOCK, MARIA ELIZABETH (NP)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ELIZABETH
Last Name:WHEELOCK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4567 QUINLAN AVE
Mailing Address - Street 2:
Mailing Address - City:JAMESVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13078-9569
Mailing Address - Country:US
Mailing Address - Phone:315-469-8286
Mailing Address - Fax:315-464-5168
Practice Address - Street 1:750 E ADAMS ST
Practice Address - Street 2:314A CON
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-2306
Practice Address - Country:US
Practice Address - Phone:315-464-3904
Practice Address - Fax:315-464-5168
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2017-08-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY420458363LW0102X
NY340687363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health