1437147055 NPI number — JUDITH A COLLINS-COX FNP, APRN, BC

Table of content: JUDITH A COLLINS-COX FNP, APRN, BC (NPI 1437147055)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437147055 NPI number — JUDITH A COLLINS-COX FNP, APRN, BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COLLINS-COX
Provider First Name:
JUDITH
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
FNP, APRN, BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437147055
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/10/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1720 7TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RADFORD
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24141-2120
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
RU STATION 6899
Provider Second Line Business Practice Location Address:
ADAMS & TYLER STREETS
Provider Business Practice Location Address City Name:
RADFORD
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24142
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-831-6667
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/07/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  0024062569 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0001062569 . This is a "VA BOARD OF MEDICINE RN" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 0024062569 . This is a "VA BOARD OF MEDICINE NP" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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