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MRS. NICOLE MARIA COOKE PMHNP-BC

>> Organized Health Care Education/Training Program >> Student

Registrant NPI Number: 1053910752

Individual Registrant:
MRS. NICOLE MARIA COOKE PMHNP-BC
Gender: F
Not Sole Proprietor

Location and contact information for practice:
5964 US HIGHWAY 90  LIVE OAK, FL 32060-8694 US
Tel: 631-388-3933  Fax: --

Contact information for business:
5964 US HIGHWAY 90  LIVE OAK, FL 32060-8694 US
Tel: 386-963-6530  Fax: --

Registration Information:
NPI: 1053910752
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N390200000XStudent
Organized Health Care Education/Training Program
FL9435338
Y363LP0808XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
FL11013322

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS FL - Page 1



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