Provider Demographics
NPI:1992125595
Name:COX, JENNIFER ELAINE (FNP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ELAINE
Last Name:COX
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3025 FOUNTAIN DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-3689
Mailing Address - Country:US
Mailing Address - Phone:501-932-5060
Mailing Address - Fax:
Practice Address - Street 1:3025 FOUNTAIN DR
Practice Address - Street 2:SUITE 100
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-3689
Practice Address - Country:US
Practice Address - Phone:501-932-5060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-22
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA004006363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily