Doctor Name: | CHARLES COOK |
NPI Number: | 1407288459 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | NP |
License Number: | 5006328 |
Business Practice Address: | 1903 Addison Ave Wilkesboro, NC - 286972262 |
Business Phone Number: | 3369816189 |
Business Fax Number: | 3366672710 |
Mailing Address: | 1903 Addison Ave, WILKESBORO |
State: | NC |
Postal Code: | 286972262 |
Phone Number: | 3369816189 |
Fax Number: | 3366672710 |
NPI Enumeration Date: | 08/01/2013 |
NPI Last Update Date: | 08/01/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2100X |
License Number: | 5006328 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Acute Care |
Taxonomy Definition: |