Provider Demographics
NPI:1669026670
Name:COX, PATRICIA LOU (CDE, MED, BSN, RN)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LOU
Last Name:COX
Suffix:
Gender:F
Credentials:CDE, MED, BSN, RN
Other - Prefix:
Other - First Name:PATI
Other - Middle Name:LH
Other - Last Name:COX
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CDE, MED, BSN, RN
Mailing Address - Street 1:1000 W 10TH ST
Mailing Address - Street 2:
Mailing Address - City:ROLLA
Mailing Address - State:MO
Mailing Address - Zip Code:65401-2905
Mailing Address - Country:US
Mailing Address - Phone:573-458-7314
Mailing Address - Fax:573-458-8486
Practice Address - Street 1:1000 W 10TH ST
Practice Address - Street 2:
Practice Address - City:ROLLA
Practice Address - State:MO
Practice Address - Zip Code:65401-2905
Practice Address - Country:US
Practice Address - Phone:573-458-7314
Practice Address - Fax:573-458-8486
Is Sole Proprietor?:No
Enumeration Date:2019-07-29
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO086802163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator