Basic Information
Provider Information
NPI: 1508304346
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COX
FirstName: ALLISON
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: BARGER
OtherFirstName: ALLISON
OtherMiddleName: ELISE
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: PA-C
OtherLastNameType: 1
Mailing Information
Address1: 701 PARK AVE
Address2:  
City: MINNEAPOLIS
State: MN
PostalCode: 554151623
CountryCode: US
TelephoneNumber: 6128733000
FaxNumber:  
Practice Location
Address1: 701 PARK AVE
Address2:  
City: MINNEAPOLIS
State: MN
PostalCode: 554151623
CountryCode: US
TelephoneNumber: 6128733000
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/01/2017
LastUpdateDate: 11/06/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000X0010-07022NCN Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 
363A00000X12537MNY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


Home