Provider Demographics
NPI:1356338461
Name:COX, CARLA ROBIN (C FNP)
Entity type:Individual
Prefix:MRS
First Name:CARLA
Middle Name:ROBIN
Last Name:COX
Suffix:
Gender:F
Credentials:C FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:275 DRY HILL RD
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-2605
Mailing Address - Country:US
Mailing Address - Phone:304-253-6060
Mailing Address - Fax:304-929-2248
Practice Address - Street 1:275 DRY HILL RD
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-2605
Practice Address - Country:US
Practice Address - Phone:304-253-6060
Practice Address - Fax:304-929-2248
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV17722363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV7105254000Medicaid
WV7105254000Medicaid