Provider Demographics
NPI:1760430490
Name:FOX, KAMI LYN (CNP)
Entity Type:Individual
Prefix:
First Name:KAMI
Middle Name:LYN
Last Name:FOX
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 HAGER ST
Mailing Address - Street 2:
Mailing Address - City:ST MARYS
Mailing Address - State:OH
Mailing Address - Zip Code:45885-2421
Mailing Address - Country:US
Mailing Address - Phone:419-394-2610
Mailing Address - Fax:419-394-6605
Practice Address - Street 1:1010 HAGER ST
Practice Address - Street 2:
Practice Address - City:ST MARYS
Practice Address - State:OH
Practice Address - Zip Code:45885-2421
Practice Address - Country:US
Practice Address - Phone:419-394-2610
Practice Address - Fax:419-394-6605
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-08822363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics