Provider Demographics
NPI:1003869231
Name:COX, KIM J (CNM, PHD)
Entity Type:Individual
Prefix:DR
First Name:KIM
Middle Name:J
Last Name:COX
Suffix:
Gender:F
Credentials:CNM, PHD
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Other - Last Name:
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Mailing Address - Street 1:2502 MARBLE AVE NE
Mailing Address - Street 2:MSC 09 5350, 1 UNIVERSITY OF NEW MEXICO
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87131-0001
Mailing Address - Country:US
Mailing Address - Phone:505-272-0850
Mailing Address - Fax:505-272-8901
Practice Address - Street 1:2502 MARBLE AVE NE
Practice Address - Street 2:MSC 09 5350, 1 UNIVERSITY OF NEW MEXICO
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:505-272-0850
Practice Address - Fax:505-272-8901
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NM615367A00000X
FLARNP1753052367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL301508400Medicaid