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Individual
FIONA M WYCOFF
Active
Individual
FIONA M WYCOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8N0136
BCBS
TX
01
—
P01054027
RAILROAD PTAN
TX
Enumeration date
01/21/2010
Last updated
08/08/2014
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