Provider Demographics
NPI:1376705863
Name:COX, KRISTY A (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:KRISTY
Middle Name:A
Last Name:COX
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MS
Other - First Name:KRISTY
Other - Middle Name:A
Other - Last Name:SCHALLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 601549
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-1549
Mailing Address - Country:US
Mailing Address - Phone:704-384-4274
Mailing Address - Fax:704-384-5636
Practice Address - Street 1:200 HAWTHORNE LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-2515
Practice Address - Country:US
Practice Address - Phone:704-384-4239
Practice Address - Fax:704-384-5636
Is Sole Proprietor?:No
Enumeration Date:2008-06-26
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC079675367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered