MEDICARE: AMY NICOLE COX RN

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	163WC0400X	Case Management Registered Nurse	233130	AK

General Provider Information

NPI Number	:	1992687495
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY NICOLE COX RN

Provider Business Mailing Address
First Line	:	PO BOX 1105
Second Line	:
City	:	TALKEETNA
State	:	AK
Zip	:	99676-1105
Country	:	US
Telephone Number	:	906-239-0224
Fax Number	:

Provider Business Practice Location Address
First Line	:	24091 W LONG LAKE RD
Second Line	:
City	:	WILLOW
State	:	AK
Zip	:	99688-0519
Country	:	US
Telephone Number	:	907-733-2273
Fax Number	:	907-733-1735

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

Provider Enumeration Date	:	07/24/2025
Last Update Date	:	07/24/2025

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