Provider Demographics
NPI:1649853649
Name:COX, MARIA ELENA (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:MARIA ELENA
Middle Name:
Last Name:COX
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2052 WHIPPOORWILL WAY
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30094-8208
Mailing Address - Country:US
Mailing Address - Phone:678-522-1716
Mailing Address - Fax:
Practice Address - Street 1:1818 LAKEFIELD CT SE STE B
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30013-6610
Practice Address - Country:US
Practice Address - Phone:678-806-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-28
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAG02210074363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology