Provider Demographics
NPI:1790114445
Name:COX, CHRISTINE MARIE (CRNP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:MARIE
Last Name:COX
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 COMMUNITY DR
Mailing Address - Street 2:SUITE E
Mailing Address - City:TOBYHANNA
Mailing Address - State:PA
Mailing Address - Zip Code:18466-8978
Mailing Address - Country:US
Mailing Address - Phone:570-839-9880
Mailing Address - Fax:570-839-9885
Practice Address - Street 1:300 COMMUNITY DR
Practice Address - Street 2:SUITE E
Practice Address - City:TOBYHANNA
Practice Address - State:PA
Practice Address - Zip Code:18466-8978
Practice Address - Country:US
Practice Address - Phone:570-839-9880
Practice Address - Fax:570-839-9885
Is Sole Proprietor?:No
Enumeration Date:2013-11-04
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN608895363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner