Provider Demographics
NPI:1760727390
Name:COX, AMY CHRISTINE (RN)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:CHRISTINE
Last Name:COX
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 E 9TH ST
Mailing Address - Street 2:
Mailing Address - City:ALTON
Mailing Address - State:IL
Mailing Address - Zip Code:62002-2524
Mailing Address - Country:US
Mailing Address - Phone:618-779-0913
Mailing Address - Fax:
Practice Address - Street 1:420 E 9TH ST
Practice Address - Street 2:
Practice Address - City:ALTON
Practice Address - State:IL
Practice Address - Zip Code:62002-2524
Practice Address - Country:US
Practice Address - Phone:618-779-0913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-08
Last Update Date:2012-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041395282163W00000X
MO2010021454163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse