Provider Demographics
NPI:1063739357
Name:WILCOX, KARIE LYNN (LPN)
Entity type:Individual
Prefix:MS
First Name:KARIE
Middle Name:LYNN
Last Name:WILCOX
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13905-2212
Mailing Address - Country:US
Mailing Address - Phone:607-769-2710
Mailing Address - Fax:607-797-4315
Practice Address - Street 1:114 CLINTON ST
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13905-2212
Practice Address - Country:US
Practice Address - Phone:607-763-2710
Practice Address - Fax:607-797-4315
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-26
Last Update Date:2010-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY280029-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse