Basic Information
Provider Information
NPI: 1134726326
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COX
FirstName: MEREDITH
MiddleName: ANN
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1544 CLOVERLY LN
Address2:  
City: RYDAL
State: PA
PostalCode: 190461405
CountryCode: US
TelephoneNumber: 2153704461
FaxNumber:  
Practice Location
Address1: 2217 BRISTOL PIKE
Address2:  
City: BENSALEM
State: PA
PostalCode: 190205736
CountryCode: US
TelephoneNumber: 2156380555
FaxNumber: 2156382929
Other Information
ProviderEnumerationDate: 10/01/2020
LastUpdateDate: 10/01/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/01/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP0200XSP022600PAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics

No ID Information.


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