Provider Demographics
NPI:1235490897
Name:COX, TRACI A (NP)
Entity Type:Individual
Prefix:MRS
First Name:TRACI
Middle Name:A
Last Name:COX
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MISS
Other - First Name:TRACI
Other - Middle Name:A
Other - Last Name:SNEED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:284 HIGHWAY 9 N
Mailing Address - Street 2:
Mailing Address - City:PONTOTOC
Mailing Address - State:MS
Mailing Address - Zip Code:38863-1536
Mailing Address - Country:US
Mailing Address - Phone:662-296-2451
Mailing Address - Fax:
Practice Address - Street 1:284 HIGHWAY 9 N
Practice Address - Street 2:
Practice Address - City:PONTOTOC
Practice Address - State:MS
Practice Address - Zip Code:38863-1536
Practice Address - Country:US
Practice Address - Phone:662-296-2451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-30
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR860656363LA2200X, 363LG0600X
MS860656363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology