Provider Demographics
NPI:1831533397
Name:WILCOX, ABIGAIL (MSN, CPNP-PC)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:WILCOX
Suffix:
Gender:F
Credentials:MSN, CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4788 HODGES BLVD
Mailing Address - Street 2:SUITE B-108
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224-7222
Mailing Address - Country:US
Mailing Address - Phone:904-223-9100
Mailing Address - Fax:904-223-9282
Practice Address - Street 1:4788 HODGES BLVD
Practice Address - Street 2:SUITE B-108
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32224-7222
Practice Address - Country:US
Practice Address - Phone:904-223-9100
Practice Address - Fax:904-223-9282
Is Sole Proprietor?:No
Enumeration Date:2013-04-26
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9181632363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics