Provider Demographics
NPI:1659674091
Name:COX, BONNIE LEE (LPN)
Entity Type:Individual
Prefix:MS
First Name:BONNIE
Middle Name:LEE
Last Name:COX
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 N 40TH ST APT D
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-1149
Mailing Address - Country:US
Mailing Address - Phone:740-877-5294
Mailing Address - Fax:
Practice Address - Street 1:91 N 40TH ST APT D
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-1149
Practice Address - Country:US
Practice Address - Phone:740-877-5294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-07
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH127862164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse