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Individual

KELLIE ELIZABETH WILCOX

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
605 S COOLIDGE ST, MOSES LAKE, WA 98837-1873
(509) 764-6111
Mailing address
PO BOX 190, TOPPENISH, WA 98948-0190
(509) 865-2395
(509) 865-0757

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201391227RN
OR
363L00000X
Nurse Practitioner
202210366NP-PP
OR
363LF0000X
Family Nurse Practitioner
Primary
AP61198829
WA

Other

Enumeration date
05/06/2019
Last updated
06/20/2025
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