Provider Demographics
NPI:1639724834
Name:COX, HANNA
Entity type:Individual
Prefix:
First Name:HANNA
Middle Name:
Last Name:COX
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 SE PLAZA AVE
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-5697
Mailing Address - Country:US
Mailing Address - Phone:479-876-8550
Mailing Address - Fax:479-208-4266
Practice Address - Street 1:901 SE PLAZA AVE
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-5697
Practice Address - Country:US
Practice Address - Phone:479-876-8550
Practice Address - Fax:479-208-4266
Is Sole Proprietor?:No
Enumeration Date:2019-08-05
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021009904363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant