Provider Demographics
NPI:1851394316
Name:COX, JANIS KELLUM (CNM,MSN)
Entity type:Individual
Prefix:MRS
First Name:JANIS
Middle Name:KELLUM
Last Name:COX
Suffix:
Gender:
Credentials:CNM,MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-6333
Mailing Address - Country:US
Mailing Address - Phone:910-353-4333
Mailing Address - Fax:910-353-2108
Practice Address - Street 1:245 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-6333
Practice Address - Country:US
Practice Address - Phone:910-353-4333
Practice Address - Fax:910-353-2108
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC CNM # 120367A00000X
NC87367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7002048Medicaid
NCQ36997AMedicare PIN