Provider Demographics
NPI:1114611977
Name:COOK, CHRISTOPHER ALLAN (APRN)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:ALLAN
Last Name:COOK
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9617 SUMMER HOUSE LN
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34212-2633
Mailing Address - Country:US
Mailing Address - Phone:941-705-3122
Mailing Address - Fax:
Practice Address - Street 1:9617 SUMMER HOUSE LN
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34212-2633
Practice Address - Country:US
Practice Address - Phone:941-705-3122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11025276363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care