Provider Demographics
NPI:1407131246
Name:COX, VIVIAN VANESSA (RN FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:VIVIAN
Middle Name:VANESSA
Last Name:COX
Suffix:
Gender:F
Credentials:RN FNP-BC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3420 22ND PL
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1314
Mailing Address - Country:US
Mailing Address - Phone:806-725-5844
Mailing Address - Fax:806-723-6532
Practice Address - Street 1:4102 24TH ST
Practice Address - Street 2:STE. 303
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1806
Practice Address - Country:US
Practice Address - Phone:806-725-7625
Practice Address - Fax:806-723-7650
Is Sole Proprietor?:No
Enumeration Date:2011-10-12
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP120978363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX198343102OtherFIRSTCARE
NM51876345Medicaid
TX8462NMOtherBCBS
TX288956003Medicaid
TX379250YKT8Medicare PIN