Provider Demographics
NPI:1972057461
Name:COX, KRISTIN KAY
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:KAY
Last Name:COX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:KAY
Other - Last Name:ROSSIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:4411 KILAUEA AVE
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-5114
Mailing Address - Country:US
Mailing Address - Phone:808-292-9859
Mailing Address - Fax:
Practice Address - Street 1:4411 KILAUEA AVE
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-5114
Practice Address - Country:US
Practice Address - Phone:808-292-9859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-12
Last Update Date:2016-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI61937163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse