Provider Demographics
NPI:1861041493
Name:COXEN, KELIE MICHELLE
Entity Type:Individual
Prefix:
First Name:KELIE
Middle Name:MICHELLE
Last Name:COXEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7865 NW MOORES VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:YAMHILL
Mailing Address - State:OR
Mailing Address - Zip Code:97148-8007
Mailing Address - Country:US
Mailing Address - Phone:971-413-3621
Mailing Address - Fax:
Practice Address - Street 1:7865 NW MOORES VALLEY RD
Practice Address - Street 2:
Practice Address - City:YAMHILL
Practice Address - State:OR
Practice Address - Zip Code:97148-8007
Practice Address - Country:US
Practice Address - Phone:971-413-3621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-06
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula