Provider Demographics
NPI:1174111686
Name:COX, TONYA CLAYTON
Entity type:Individual
Prefix:MRS
First Name:TONYA
Middle Name:CLAYTON
Last Name:COX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3505 VILLAGE DR STE 201
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-4514
Mailing Address - Country:US
Mailing Address - Phone:910-323-0065
Mailing Address - Fax:
Practice Address - Street 1:3505 VILLAGE DR STE 201
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-4514
Practice Address - Country:US
Practice Address - Phone:910-323-0065
Practice Address - Fax:910-323-0071
Is Sole Proprietor?:No
Enumeration Date:2021-01-10
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NC5015997363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program