MEDICARE: ARIEL E WILCOX R.N.

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	163W00000X	Registered Nurse	025932	ME

General Provider Information

NPI Number	:	1851500219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARIEL E WILCOX R.N.

Provider Business Mailing Address
First Line	:	426 FOREST AVENUE
Second Line	:	ACCESS WELLNESS
City	:	PORTLAND
State	:	ME
Zip	:	04101-5513
Country	:	US
Telephone Number	:	207-553-7077
Fax Number	:

Provider Business Practice Location Address
First Line	:	426 FOREST AVENUE
Second Line	:	ACCESS WELLNESS
City	:	PORTLAND
State	:	ME
Zip	:	04101-5513
Country	:	US
Telephone Number	:	207-553-7077
Fax Number	:

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

Provider Enumeration Date	:	05/22/2007
Last Update Date	:	02/11/2008

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