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Individual
KIMBERLY J WILCOX
Active
Individual
KIMBERLY J WILCOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
148836
WI
367500000X
Certified Registered Nurse Anesthetist
072750
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
44339100
—
WI
Enumeration date
07/12/2007
Last updated
03/30/2022
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