| Doctor Name: | MICHELLE COX |
| NPI Number: | 1043484371 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CPNP |
| License Number: | 2003020311 |
| Business Practice Address: | 100 Brevco Plz Suite 101 Lake St Louis, MO - 633671392 |
| Business Phone Number: | 6365615437 |
| Business Fax Number: | 6365615100 |
| Mailing Address: | 100 Brevco Plz, Suite 101 LAKE ST LOUIS |
| State: | MO |
| Postal Code: | 633671392 |
| Phone Number: | 6365615437 |
| Fax Number: | 6365615100 |
| NPI Enumeration Date: | 04/17/2008 |
| NPI Last Update Date: | 12/23/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 2003020311 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |