Healthcare Provider Details

I. General information

NPI: 1144343179
Provider Name (Legal Business Name): JO ELLEN COX MS, RD, LD, CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 PLEASANT ST
DES MOINES IA
50309-1406
US

IV. Provider business mailing address

4125 COLLEGE AVE
DES MOINES IA
50311-2534
US

V. Phone/Fax

Practice location:
  • Phone: 515-241-3220
  • Fax: 515-241-5055
Mailing address:
  • Phone: 515-277-8599
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number00729
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: