Provider Demographics
NPI:1871063289
Name:WILCOX, CYNTHIA S (LPN)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:S
Last Name:WILCOX
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1487 BALFOUR LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-5301
Mailing Address - Country:US
Mailing Address - Phone:513-609-8485
Mailing Address - Fax:513-918-2100
Practice Address - Street 1:1487 BALFOUR LN
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-5301
Practice Address - Country:US
Practice Address - Phone:513-609-8485
Practice Address - Fax:513-918-2100
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-28
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH160706164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse