Provider Demographics
NPI:1164123634
Name:ROOK, RICK (RN)
Entity Type:Individual
Prefix:
First Name:RICK
Middle Name:
Last Name:ROOK
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 MARSHALL DR
Mailing Address - Street 2:
Mailing Address - City:SWANTON
Mailing Address - State:OH
Mailing Address - Zip Code:43558-1421
Mailing Address - Country:US
Mailing Address - Phone:419-559-1439
Mailing Address - Fax:
Practice Address - Street 1:5351 MITCHAW RD
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-9406
Practice Address - Country:US
Practice Address - Phone:419-824-6699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH455103163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse