Provider Demographics
NPI:1922839950
Name:COX, JESSICA JANE
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:JANE
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 1:113 GOLDEN BEAR DR # 26
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:WV
Mailing Address - Zip Code:25136-2383
Mailing Address - Country:US
Mailing Address - Phone:304-220-9514
Mailing Address - Fax:
Practice Address - Street 1:113 GOLDEN BEAR DR # 26
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:WV
Practice Address - Zip Code:25136-2383
Practice Address - Country:US
Practice Address - Phone:304-220-9514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant