Doctor Name: | DELORES GWENDOLYN COOK |
NPI Number: | 1134267198 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 505742 |
Business Practice Address: | 400 Hospital Dr Suite #106 Corsicana, TX - 751102489 |
Business Phone Number: | 9038722923 |
Business Fax Number: | 9038722941 |
Mailing Address: | 401 Hospital Dr, Suite 120 CORSICANA |
State: | TX |
Postal Code: | 751102415 |
Phone Number: | 9038723005 |
Fax Number: | 9038723050 |
NPI Enumeration Date: | 02/02/2007 |
NPI Last Update Date: | 03/07/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 505742 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |