Provider Demographics
NPI:1962635359
Name:WILCOX, JOY DEANE (APN)
Entity Type:Individual
Prefix:MRS
First Name:JOY
Middle Name:DEANE
Last Name:WILCOX
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10780
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-0013
Mailing Address - Country:US
Mailing Address - Phone:501-513-0799
Mailing Address - Fax:501-513-0798
Practice Address - Street 1:455 HOGAN LN
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-8201
Practice Address - Country:US
Practice Address - Phone:501-513-0799
Practice Address - Fax:501-513-0798
Is Sole Proprietor?:No
Enumeration Date:2009-09-01
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA03290 ANP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner