Provider Demographics
NPI:1144813106
Name:COX, LAURA (AGNP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:COX
Suffix:
Gender:F
Credentials:AGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9203 S FREEMAN DR
Mailing Address - Street 2:
Mailing Address - City:MEDICAL LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99022-8504
Mailing Address - Country:US
Mailing Address - Phone:702-327-7589
Mailing Address - Fax:
Practice Address - Street 1:9203 S FREEMAN DR
Practice Address - Street 2:
Practice Address - City:MEDICAL LAKE
Practice Address - State:WA
Practice Address - Zip Code:99022-8504
Practice Address - Country:US
Practice Address - Phone:702-327-7589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-19
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAG10200185363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology