Healthcare Provider Details

I. General information

NPI: 1669139283
Provider Name (Legal Business Name): KASEY ANN COX FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KASEY ANN WHALEY

II. Dates (important events)

Enumeration Date: 11/18/2021
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 MAIN ST S
MINOT ND
58701-3914
US

IV. Provider business mailing address

108 MAIN ST S
MINOT ND
58701-3914
US

V. Phone/Fax

Practice location:
  • Phone: 701-852-5070
  • Fax:
Mailing address:
  • Phone: 701-852-5070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number205559
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: