Provider Demographics
NPI:1033743745
Name:COOK, CHRISTOPHER LEANDER
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:LEANDER
Last Name:COOK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3615 SILVER PARK DR APT 201
Mailing Address - Street 2:
Mailing Address - City:SUITLAND
Mailing Address - State:MD
Mailing Address - Zip Code:20746-2933
Mailing Address - Country:US
Mailing Address - Phone:202-910-4676
Mailing Address - Fax:
Practice Address - Street 1:3615 SILVER PARK DR APT 201
Practice Address - Street 2:
Practice Address - City:SUITLAND
Practice Address - State:MD
Practice Address - Zip Code:20746-2933
Practice Address - Country:US
Practice Address - Phone:202-910-4676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-03
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No372500000XNursing Service Related ProvidersChore Provider
No374U00000XNursing Service Related ProvidersHome Health Aide