Provider Demographics
NPI:1427462043
Name:FOX, KATHERINE HELEN (FNP-C)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:HELEN
Last Name:FOX
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1121 1/2 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37160-2309
Mailing Address - Country:US
Mailing Address - Phone:931-735-6003
Mailing Address - Fax:937-237-4748
Practice Address - Street 1:1121 1/2 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37160
Practice Address - Country:US
Practice Address - Phone:931-735-6003
Practice Address - Fax:931-735-6152
Is Sole Proprietor?:No
Enumeration Date:2014-06-12
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN21122207QB0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QB0002XAllopathic & Osteopathic PhysiciansFamily MedicineObesity Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN6198511OtherBLUECROSS BLUESHIELD OF TENNESSEE
TNQ052457Medicaid
OH0105376Medicaid