Provider Demographics
NPI:1093756538
Name:COX, VIRGINIA L (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:L
Last Name:COX
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1027
Mailing Address - Street 2:
Mailing Address - City:FITZGERALD
Mailing Address - State:GA
Mailing Address - Zip Code:31750-1027
Mailing Address - Country:US
Mailing Address - Phone:229-426-7685
Mailing Address - Fax:
Practice Address - Street 1:808 S GRANT ST
Practice Address - Street 2:
Practice Address - City:FITZGERALD
Practice Address - State:GA
Practice Address - Zip Code:31750-3703
Practice Address - Country:US
Practice Address - Phone:229-426-7685
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN101986363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAQ03884Medicare UPIN
GA50BBKJPMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER