Healthcare Provider Details

I. General information

NPI: 1386559003
Provider Name (Legal Business Name): CORRIE COX
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3277 E LOUISE DR STE 275
MERIDIAN ID
83642-9359
US

IV. Provider business mailing address

3277 E LOUISE DR STE 275
MERIDIAN ID
83642-9359
US

V. Phone/Fax

Practice location:
  • Phone: 208-753-2400
  • Fax: 208-266-6284
Mailing address:
  • Phone: 208-753-2400
  • Fax: 208-266-6284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0121X
TaxonomyPlastic Surgery Registered Nurse
License Number31554
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: