Provider Demographics
NPI:1982101168
Name:COX, BETH COLLEEN (LVN)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:COLLEEN
Last Name:COX
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 S E 0060
Mailing Address - Street 2:
Mailing Address - City:CORSICANA
Mailing Address - State:TX
Mailing Address - Zip Code:75109
Mailing Address - Country:US
Mailing Address - Phone:972-370-8546
Mailing Address - Fax:
Practice Address - Street 1:1001 N 31ST ST
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76707-2507
Practice Address - Country:US
Practice Address - Phone:254-723-3605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-12
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX311215164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse