Individual ProviderTraci CoxNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address9900 Bren Rd E, Minnetonka, MN 55343-9664(423) 342-6016PECOS EnrollmentBased on the most recent information from CMS, provider Traci Cox is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1932517737Provider TypeIndividualFull NameCox, TraciCredentialNP-CGenderFemaleSole ProprietorNoEnumeration Date7/25/2014Last Updated7/11/2020Contact InformationPractice LocationPractice Address9900 Bren Rd E, Minnetonka, MN 55343-9664Phone(423) 342-6016FaxUnlisted FaxMailing LocationMailing Address154 El Bowers Road, Elizabethton, TN 37643Phone(423) 342-6016FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363L00000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense18747TennesseeProvider IdentifiersIDDescriptionIssuerIDQ008897DescriptionMedicaidIssuerUnlistedTennesseeID1932517737DescriptionMedicaidIssuerUnlistedVirginia