Provider Demographics
NPI:1134657836
Name:COX, TAMRA LYNN (MSN, RN, NP-C)
Entity Type:Individual
Prefix:MS
First Name:TAMRA
Middle Name:LYNN
Last Name:COX
Suffix:
Gender:F
Credentials:MSN, RN, NP-C
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:PO BOX 497
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:AR
Mailing Address - Zip Code:72006-0497
Mailing Address - Country:US
Mailing Address - Phone:870-347-2435
Mailing Address - Fax:870-301-2092
Practice Address - Street 1:3150 E HERITAGE PKWY
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:AR
Practice Address - Zip Code:72730-5529
Practice Address - Country:US
Practice Address - Phone:479-400-1140
Practice Address - Fax:479-400-1151
Is Sole Proprietor?:No
Enumeration Date:2017-05-25
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AR001126363LF0000X
TN22501363LF0000X
ARA005385363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR225156758Medicaid