Provider Demographics
NPI:1013385574
Name:COOK, DE'ANNA TA'LETTE (RN)
Entity Type:Individual
Prefix:
First Name:DE'ANNA
Middle Name:TA'LETTE
Last Name:COOK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3251 E 142ND ST
Mailing Address - Street 2:UPSTAIRS
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44120-4006
Mailing Address - Country:US
Mailing Address - Phone:216-224-1032
Mailing Address - Fax:
Practice Address - Street 1:3251 E 142ND ST
Practice Address - Street 2:UPSTAIRS
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44120-4006
Practice Address - Country:US
Practice Address - Phone:216-224-1032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-14
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.412679-163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse