Basic Information
Provider Information
NPI: 1760595292
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COX
FirstName: ANN
MiddleName: M
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
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Mailing Information
Address1: 233 HOOKANO ST
Address2:  
City: HILO
State: HI
PostalCode: 967206216
CountryCode: US
TelephoneNumber: 9704133776
FaxNumber: 8335361752
Practice Location
Address1: 75-5751 KUAKINI HWY
Address2:  
City: KAILUA KONA
State: HI
PostalCode: 967401752
CountryCode: US
TelephoneNumber: 8083265629
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/17/2006
LastUpdateDate: 09/27/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: Y
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate: 09/27/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP0808XAPN.0003922-NPCOY193200000X MULTI-SPECIALTY GROUPPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsych/Mental Health

No ID Information.


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