MEDICARE: JENNIFER M COX FNP/PMHNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	71001901	IN
2	363LF0000X	Family Nurse Practitioner	71001901A	IN
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	71001901A	IN

General Provider Information

NPI Number	:	1528008893
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER M COX FNP/PMHNP

Provider Business Mailing Address
First Line	:	4105 E DALLAS DR
Second Line	:
City	:	TERRE HAUTE
State	:	IN
Zip	:	47802-9540
Country	:	US
Telephone Number	:	812-240-4446
Fax Number	:

Provider Business Practice Location Address
First Line	:	4105 E DALLAS DR
Second Line	:
City	:	TERRE HAUTE
State	:	IN
Zip	:	47802-9540
Country	:	US
Telephone Number	:	812-240-4446
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	08/20/2024

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