Provider Demographics
NPI:1609884014
Name:COX, SARAH REDBIRD (CNM)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:REDBIRD
Last Name:COX
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:
Other - Last Name:WEINBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4086 HAWTHORNE WAY
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83703-3923
Mailing Address - Country:US
Mailing Address - Phone:208-343-4433
Mailing Address - Fax:
Practice Address - Street 1:777 N RAYMOND ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-9251
Practice Address - Country:US
Practice Address - Phone:208-514-2500
Practice Address - Fax:208-322-7018
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2009-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCNM-27A367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID807551600Medicaid
ID807551600Medicaid