Provider Demographics
NPI:1861218075
Name:COURTNEYCOXPMHNP, LLC
Entity type:Organization
Organization Name:COURTNEYCOXPMHNP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:337-258-6227
Mailing Address - Street 1:126 ANATOLE DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-8179
Mailing Address - Country:US
Mailing Address - Phone:337-258-6227
Mailing Address - Fax:
Practice Address - Street 1:709 SAINT JOHN ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70501-6705
Practice Address - Country:US
Practice Address - Phone:337-258-6227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-03
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty