Provider Demographics
NPI:1376299123
Name:COX, TRACEY ALANE
Entity Type:Individual
Prefix:MRS
First Name:TRACEY
Middle Name:ALANE
Last Name:COX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5474 GOANS PL
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44134-2102
Mailing Address - Country:US
Mailing Address - Phone:440-334-7405
Mailing Address - Fax:
Practice Address - Street 1:5474 GOANS PL
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44134-2102
Practice Address - Country:US
Practice Address - Phone:440-334-7405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-01
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant