Provider Demographics
NPI:1588277669
Name:WILCOX, SARAH ELIZABETH RUTH (CNP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ELIZABETH RUTH
Last Name:WILCOX
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3146 GRANGE HILL PL
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-1794
Mailing Address - Country:US
Mailing Address - Phone:614-323-0405
Mailing Address - Fax:
Practice Address - Street 1:3146 GRANGE HILL PL
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-1794
Practice Address - Country:US
Practice Address - Phone:614-323-0405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2020-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0026988207Q00000X
OHAPRN.CNP.00269888363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine