Provider Demographics
NPI:1093812638
Name:FOX, CHRIS S (CRNA)
Entity Type:Individual
Prefix:MS
First Name:CHRIS
Middle Name:S
Last Name:FOX
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:CHRIS
Other - Middle Name:S
Other - Last Name:FOX
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNA, DNPC
Mailing Address - Street 1:7 HOLLY HILL RD
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36305-1150
Mailing Address - Country:US
Mailing Address - Phone:334-702-3302
Mailing Address - Fax:
Practice Address - Street 1:7 HOLLY HILL RD
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36305-1150
Practice Address - Country:US
Practice Address - Phone:334-702-3302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL282NC0060X
FL9189197367500000X
AL1-055786367500000X
NMR878528367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL308638100Medicaid