Provider Demographics
NPI:1598368102
Name:COX, PAMELA ANN
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:ANN
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 1:37 SOUTH STREET
Mailing Address - Street 2:PO411
Mailing Address - City:CLARKSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45113-0411
Mailing Address - Country:US
Mailing Address - Phone:937-289-0140
Mailing Address - Fax:
Practice Address - Street 1:37 SOUTH STREET
Practice Address - Street 2:PO411
Practice Address - City:CLARKSVILLE
Practice Address - State:OH
Practice Address - Zip Code:45113-0411
Practice Address - Country:US
Practice Address - Phone:937-289-0140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide