Provider Demographics
NPI:1679022271
Name:COX, KELSIE LEANN (MSN, APRN, CPNP, NNP)
Entity Type:Individual
Prefix:MRS
First Name:KELSIE
Middle Name:LEANN
Last Name:COX
Suffix:
Gender:F
Credentials:MSN, APRN, CPNP, NNP
Other - Prefix:
Other - First Name:KELSIE
Other - Middle Name:LEANN
Other - Last Name:MCCARTHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, APRN, CPNP
Mailing Address - Street 1:507 MARLANDWOOD RD APT 525
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-3690
Mailing Address - Country:US
Mailing Address - Phone:972-489-2636
Mailing Address - Fax:
Practice Address - Street 1:1201 W 38TH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1006
Practice Address - Country:US
Practice Address - Phone:512-324-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-25
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX828097163W00000X
TXAP131871363LP0200X, 363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
No163W00000XNursing Service ProvidersRegistered Nurse
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics