MEDICARE: MS. VICKI L WILCOXSON APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	SP007353	PA
2	163W00000X	Registered Nurse	RN536557	PA
3	363LA2100X	Acute Care Nurse Practitioner	ARNP9438475	FL
4	363LA2100X	Acute Care Nurse Practitioner	SP007353	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	867633	OTHER	PA	MEDICARE GROUP #

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	25-1716306	OTHER	PA	DEVON
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	SP007353	OTHER	PA	LICENSE
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215912027
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. VICKI L WILCOXSON APRN

Provider Business Mailing Address
First Line	:	601 MEMORY LN
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17402-2231
Country	:	US
Telephone Number	:	717-851-1405
Fax Number	:	717-851-6969

Provider Business Practice Location Address
First Line	:	22 ST PAUL DR
Second Line	:
City	:	CHAMBERSBURG
State	:	PA
Zip	:	17201-1036
Country	:	US
Telephone Number	:	717-217-6944
Fax Number	:	717-303-3729

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	01/22/2026

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