Provider Demographics
NPI:1003495920
Name:COX, BEVERLY JANE
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:JANE
Last Name:COX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BEVERLY
Other - Middle Name:JANE
Other - Last Name:COX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17782 RT 52
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45144
Mailing Address - Country:US
Mailing Address - Phone:606-541-0772
Mailing Address - Fax:
Practice Address - Street 1:17782 RT 52
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:OH
Practice Address - Zip Code:45144
Practice Address - Country:US
Practice Address - Phone:606-541-0772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-07
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide