Provider Demographics
NPI:1740348689
Name:COX, VALERIE JEAN
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:JEAN
Last Name:COX
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 1:615 S BELTLINE HWY W
Mailing Address - Street 2:SUITE # 3
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-1318
Mailing Address - Country:US
Mailing Address - Phone:308-633-2843
Mailing Address - Fax:
Practice Address - Street 1:615 S BELTLINE HWY W
Practice Address - Street 2:SUITE # 3
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-1318
Practice Address - Country:US
Practice Address - Phone:308-633-2843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1157111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE09733OtherBLUE CROSS BLUE SHIELD
NE10025268000Medicaid
NE10025268000Medicaid