Provider Demographics
NPI:1306410956
Name:COX, SARAH DAWN (NP)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:DAWN
Last Name:COX
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3456 E 17TH ST
Mailing Address - Street 2:STE 190
Mailing Address - City:AMMON
Mailing Address - State:ID
Mailing Address - Zip Code:83406-6749
Mailing Address - Country:US
Mailing Address - Phone:208-523-3857
Mailing Address - Fax:
Practice Address - Street 1:2141 CORONADO ST
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83404-7495
Practice Address - Country:US
Practice Address - Phone:208-523-3857
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-18
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID68016363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily