Provider Demographics
NPI:1477221620
Name:COX, MARY JANE
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:JANE
Last Name:COX
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:MARY
Other - Middle Name:JANE
Other - Last Name:ELLIOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:94 HANSON ST
Mailing Address - Street 2:
Mailing Address - City:BUCKHANNON
Mailing Address - State:WV
Mailing Address - Zip Code:26201-8717
Mailing Address - Country:US
Mailing Address - Phone:304-457-2481
Mailing Address - Fax:
Practice Address - Street 1:94 HANSON ST
Practice Address - Street 2:
Practice Address - City:BUCKHANNON
Practice Address - State:WV
Practice Address - Zip Code:26201-8717
Practice Address - Country:US
Practice Address - Phone:304-457-2481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-02
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant