Provider Demographics
NPI:1902977317
Name:COX, BRENDA L (RNCNP)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:L
Last Name:COX
Suffix:
Gender:F
Credentials:RNCNP
Other - Prefix:
Other - First Name:BRENDA
Other - Middle Name:L
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RNCNP
Mailing Address - Street 1:1050 REID PARKWAY
Mailing Address - Street 2:SUITE 220
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374-1907
Mailing Address - Country:US
Mailing Address - Phone:765-962-9541
Mailing Address - Fax:765-966-5952
Practice Address - Street 1:1050 REID PKWY
Practice Address - Street 2:SUITE 220
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-1155
Practice Address - Country:US
Practice Address - Phone:765-962-9541
Practice Address - Fax:765-966-5952
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001114A363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
902530FMedicare ID - Type Unspecified