Provider Demographics
NPI:1225401623
Name:FOX, RAJENE GERETTE (NP)
Entity Type:Individual
Prefix:
First Name:RAJENE
Middle Name:GERETTE
Last Name:FOX
Suffix:
Gender:F
Credentials:NP
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 1450
Mailing Address - Street 2:
Mailing Address - City:COSHOCTON
Mailing Address - State:OH
Mailing Address - Zip Code:43812-6450
Mailing Address - Country:US
Mailing Address - Phone:740-202-0936
Mailing Address - Fax:
Practice Address - Street 1:311 S 15TH ST
Practice Address - Street 2:SUITE 202
Practice Address - City:COSHOCTON
Practice Address - State:OH
Practice Address - Zip Code:43812-1873
Practice Address - Country:US
Practice Address - Phone:740-295-3328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-06
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.18364-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily