Provider Demographics
NPI:1154869824
Name:WILCOX, TEMERIA (CRNP)
Entity type:Individual
Prefix:MRS
First Name:TEMERIA
Middle Name:
Last Name:WILCOX
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22196 THREE NOTCH RD
Mailing Address - Street 2:STE 104
Mailing Address - City:LEXINGTON PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20653-2008
Mailing Address - Country:US
Mailing Address - Phone:240-237-8557
Mailing Address - Fax:
Practice Address - Street 1:20945 GREAT MILLS RD
Practice Address - Street 2:SUITE 203
Practice Address - City:LEXINGTON PARK
Practice Address - State:MD
Practice Address - Zip Code:20653-4369
Practice Address - Country:US
Practice Address - Phone:240-237-8557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR202461363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily