Provider Demographics
NPI:1912613472
Name:COX, JIMMY DEAN (FNP)
Entity Type:Individual
Prefix:MR
First Name:JIMMY
Middle Name:DEAN
Last Name:COX
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:MR
Other - First Name:JAMES
Other - Middle Name:DEAN
Other - Last Name:COX
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:7557B DANNAHER DR STE 225
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37849-3568
Mailing Address - Country:US
Mailing Address - Phone:865-859-7330
Mailing Address - Fax:865-859-7339
Practice Address - Street 1:7557B DANNAHER DR STE 225
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:TN
Practice Address - Zip Code:37849-3568
Practice Address - Country:US
Practice Address - Phone:865-859-7330
Practice Address - Fax:865-859-7339
Is Sole Proprietor?:No
Enumeration Date:2023-01-27
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN33315363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner