Provider Demographics
NPI:1447956131
Name:WILCOX, MICHELLE M (FNP-C)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:M
Last Name:WILCOX
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 E THRIVE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:UT
Mailing Address - Zip Code:84045-5552
Mailing Address - Country:US
Mailing Address - Phone:801-756-9635
Mailing Address - Fax:
Practice Address - Street 1:118 E THRIVE DR STE 200
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:UT
Practice Address - Zip Code:84045-5552
Practice Address - Country:US
Practice Address - Phone:801-756-9635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-03
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT270643-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily