Provider Demographics
NPI:1053744995
Name:COX, JESSICA ANN (BA PSYCHOLOGY)
Entity type:Individual
Prefix:MISS
First Name:JESSICA
Middle Name:ANN
Last Name:COX
Suffix:
Gender:F
Credentials:BA PSYCHOLOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 LEMON LN
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:OK
Mailing Address - Zip Code:74868-9458
Mailing Address - Country:US
Mailing Address - Phone:405-380-4503
Mailing Address - Fax:
Practice Address - Street 1:503 LEMON LN
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:OK
Practice Address - Zip Code:74868-9458
Practice Address - Country:US
Practice Address - Phone:405-380-4503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-14
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK37V980370610376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide