Provider Demographics
NPI:1730962622
Name:COX, JESSICA L (FNP-BC)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:L
Last Name:COX
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 NESBIT DR
Mailing Address - Street 2:
Mailing Address - City:BONNE TERRE
Mailing Address - State:MO
Mailing Address - Zip Code:63628-1353
Mailing Address - Country:US
Mailing Address - Phone:573-358-1700
Mailing Address - Fax:573-358-1702
Practice Address - Street 1:55 NESBIT DR
Practice Address - Street 2:
Practice Address - City:BONNE TERRE
Practice Address - State:MO
Practice Address - Zip Code:63628-1353
Practice Address - Country:US
Practice Address - Phone:573-358-1700
Practice Address - Fax:573-358-1702
Is Sole Proprietor?:No
Enumeration Date:2023-08-15
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023030184363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner