Healthcare Provider Details

I. General information

NPI: 1629987664
Provider Name (Legal Business Name): KIMBERLY NICOLE COX PNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2895 LEWIS LN
PARIS TX
75460-9331
US

IV. Provider business mailing address

PO BOX 2709
LONGVIEW TX
75606-2709
US

V. Phone/Fax

Practice location:
  • Phone: 903-782-9206
  • Fax: 903-785-2322
Mailing address:
  • Phone: 903-234-0776
  • Fax: 903-234-9769

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number124654
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: