Provider Demographics
NPI:1043273493
Name:COOK, ROBIN SUZETTE (NP)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:SUZETTE
Last Name:COOK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:BROWN
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-384-7840
Mailing Address - Fax:704-384-7830
Practice Address - Street 1:1995 WELLNESS BLVD
Practice Address - Street 2:STUITE 110, BLDG B
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110-7769
Practice Address - Country:US
Practice Address - Phone:704-384-1140
Practice Address - Fax:704-384-1141
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201512363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7005672Medicaid
NC2808941Medicare PIN