MS. VICKI L WILCOXSON (NPI# 1215912027) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215912027 |
| Entity Type | Individual |
| Full Name | MS. VICKI L WILCOXSON |
| Credential | APRN |
| Practice Address |
303 N Clyde Morris Blvd Ste 302 Daytona Beach FL 32114-2709 |
| Mailing Address |
303 N Clyde Morris Blvd Daytona Beach FL 32114-2709 |
| Practice Telephone | 3864254542 |
| Practice Fax Number | 3864257705 |
| Mailing Telephone | 3864250141 |
| Mailing Fax Number | 3862264577 |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2020-06-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | RN536557 | PA | Nursing Service Providers |
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
ARNP9438475 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
SP007353 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | MEDICARE GROUP # | 867633 | 01 |
| PA | LICENSE | SP007353 | 01 |
| PA | DEVON | 25-1716306 | 01 |
| PA | MEDICAID GROUP # | 1007307260034 | 01 |
| PA | DEA | MW1032729 | 01 |
| Street Address |
303 N CLYDE MORRIS BLVD STE 302 |
| City | DAYTONA BEACH |
| State | FL |
| Zip Code | 32114-2709 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376161380 | Evolution Health & Performance LLC | Physician Assistant | 244 S. Palmetto Ave, Daytona Beach, FL 32114 | 2020-07-07 |
| 1407480189 | Kierra Imani Kinsey | Behavior Technician | 1128-a Beville Rd, Daytona Beach, FL 32114 | 2020-03-02 |
| 1043776057 | Outreach Community Care Network Inc | Pharmacy | 240 N. Frederick Avenue, Daytona Beach, FL 32114 | 2019-02-14 |
| 1033681861 | Katherine Proppe | Specialist/Technologist | 1 Aerospace Blvd, Daytona Beach, FL 32114 | 2018-12-18 |
| 1841765047 | Anna L Smith | Nurse Practitioner | 339 Bill France Blvd Ste C, Daytona Beach, FL 32114 | 2018-10-04 |
| 1154806933 | Steve Anthony Lee | Family Medicine | 731 N. Clyde Morris Blvd, Daytona Beach, FL 32114 | 2018-09-27 |
| 1285116491 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1348 W International Speedway Blvd Ste 2, Daytona Beach, FL 32114 | 2018-09-04 |
| 1770085656 | Merina Lee | Occupational Therapist | 1159 Australia Ave., Daytona Beach, FL 32114 | 2018-03-06 |
| 1346752755 | Hand & Upper Extremity Surgery of Daytona Beach, LLC | Non-Pharmacy Dispensing Site | 1241 Ridgewood Ave, Daytona Beach, FL 32114 | 2017-10-26 |
| 1104347053 | Harry Herman Blanke IIi | Family Medicine | 201 N Clyde Morris Blvd, Suite 200, Halifax Health Family Medicine Residency Program, Daytona Beach, FL 32114 | 2017-06-30 |
| Find all providers in zip 32114 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952784779 | Kathryn Brenna Copley | Nurse Practitioner | 1890 Lpga Blvd., Daytona Beach, FL 32117 | 2015-06-30 |
| 1902213903 | Sharon Besche Craddock | Nurse Practitioner | 544 Health Boulevard, Daytona Beach, FL 32114 | 2014-07-22 |
| 1790385029 | James Edward Collie | Nurse Practitioner | 301 Memorial Medical Pkwy, Daytona Beach, FL 32117-5167 | 2020-10-27 |
| 1679117477 | Amanda Paterson | Nurse Practitioner | 1890 Lpga Blvd Ste 250, Daytona Beach, FL 32117-7131 | 2019-11-05 |
| 1265919013 | Jennifer Leuzinger | Nurse Practitioner | 301 Memorial Medical Pkwy, Daytona Beach, FL 32117-5167 | 2018-07-24 |
| 1982127544 | Susan Farrenkopf | Nurse Practitioner | 301 Memorial Medical Pkwy, Daytona Beach, FL 32117-5167 | 2017-07-25 |
| 1639607070 | Miranda Leigh Pelzel | Nurse Practitioner | 305 Memorial Medical Pkwy Ste 308, Daytona Beach, FL 32117 | 2017-05-30 |
| 1861946204 | Shealean Lewis | Nurse Practitioner | 303 N Clyde Morris Blvd, Daytona Beach, FL 32114-2709 | 2016-08-14 |
| 1821440694 | Justine Frances Fager-bennett | Nurse Practitioner | 303 N Clyde Morris Blvd, Daytona Beach, FL 32114-2709 | 2016-07-06 |
| 1306292925 | Alejandra Linares | Nurse Practitioner | 301 Memorial Medical Pkwy, Daytona Beach, FL 32117-5167 | 2016-05-12 |
| Find all providers in DAYTONA BEACH | ||||
| City | DAYTONA BEACH |
| Zip Code | 32114 |
Please comment or provide details below to improve the information on MS. VICKI L WILCOXSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.