Basic Information
Provider Information
NPI: 1790755783
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COX
FirstName: CAREY
MiddleName: LIANA
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 13523 BARRETT PARKWAY DRIVE
Address2: SUITE 104
City: BALLWIN
State: MO
PostalCode: 630213802
CountryCode: US
TelephoneNumber: 6369386868
FaxNumber: 6369381486
Practice Location
Address1: 45 THOMAS JOHNSON DRIVE
Address2: SUITE 207
City: FREDERICK
State: MD
PostalCode: 217024425
CountryCode: US
TelephoneNumber: 3016943400
FaxNumber: 3016943620
Other Information
ProviderEnumerationDate: 01/24/2006
LastUpdateDate: 09/28/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X050609MNN Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 
367500000XR188919MDY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 
367500000XRN1018355DCN Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 
367500000XR120483-4MNN Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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