Provider Demographics
NPI:1164078192
Name:COX, TERESA R (ARNP)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:R
Last Name:COX
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1711 WILLAMETTE STREET
Mailing Address - Street 2:SUITE 301, #140
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-4593
Mailing Address - Country:US
Mailing Address - Phone:541-255-1411
Mailing Address - Fax:541-255-1412
Practice Address - Street 1:1551 OAK ST STE B
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-4023
Practice Address - Country:US
Practice Address - Phone:541-255-1411
Practice Address - Fax:541-255-1412
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-15
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60989907363LP0808X
OR201907776NP-PP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health