Provider Demographics
NPI:1518977834
Name:COX, ANITA MARIE (APRN, BC)
Entity Type:Individual
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First Name:ANITA
Middle Name:MARIE
Last Name:COX
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Gender:F
Credentials:APRN, BC
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Mailing Address - Street 1:670 MASON RIDGE CENTER DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8573
Mailing Address - Country:US
Mailing Address - Phone:660-263-1225
Mailing Address - Fax:660-263-1613
Practice Address - Street 1:1600 N MORLEY ST
Practice Address - Street 2:SUITE 120A
Practice Address - City:MOBERLY
Practice Address - State:MO
Practice Address - Zip Code:65270-3666
Practice Address - Country:US
Practice Address - Phone:660-263-1225
Practice Address - Fax:660-263-1613
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2012-02-17
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Provider Licenses
StateLicense IDTaxonomies
MO069204363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO421664509Medicaid
MOP00346554OtherRAILROAD MEDICARE
MO421664509Medicaid