Provider Demographics
NPI:1780141861
Name:COX, MOLLY ANNE (PA)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:ANNE
Last Name:COX
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:ANNE
Other - Last Name:NICHOLLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:PO BOX 485
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:IN
Mailing Address - Zip Code:47362-0485
Mailing Address - Country:US
Mailing Address - Phone:765-521-7385
Mailing Address - Fax:765-521-7394
Practice Address - Street 1:2200 FOREST RIDGE PKWY STE 240
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:IN
Practice Address - Zip Code:47362-2943
Practice Address - Country:US
Practice Address - Phone:765-521-7385
Practice Address - Fax:765-521-7394
Is Sole Proprietor?:No
Enumeration Date:2019-02-26
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant