Provider Demographics
NPI:1841371903
Name:COX, THERESA DARLENE (PA)
Entity type:Individual
Prefix:MS
First Name:THERESA
Middle Name:DARLENE
Last Name:COX
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:TESS
Other - Middle Name:
Other - Last Name:COX
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA-C, MHSC
Mailing Address - Street 1:2088 PRINCESS ANNE RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-4014
Mailing Address - Country:US
Mailing Address - Phone:757-668-6715
Mailing Address - Fax:757-668-6680
Practice Address - Street 1:7423 GRANBY ST
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23505-3406
Practice Address - Country:US
Practice Address - Phone:757-451-5000
Practice Address - Fax:757-451-5005
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110840436208000000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA012874J90Medicare UPIN