Provider Demographics
NPI:1275688111
Name:COOKE, LOUISE ELIZABETH (RN)
Entity Type:Individual
Prefix:
First Name:LOUISE
Middle Name:ELIZABETH
Last Name:COOKE
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 1:25 NAIRN LN
Mailing Address - Street 2:
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701
Mailing Address - Country:US
Mailing Address - Phone:302-834-7761
Mailing Address - Fax:302-834-7761
Practice Address - Street 1:25 NAIRN LN
Practice Address - Street 2:
Practice Address - City:BEAR
Practice Address - State:DE
Practice Address - Zip Code:19701-4759
Practice Address - Country:US
Practice Address - Phone:302-834-7761
Practice Address - Fax:302-834-7761
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0019333163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000965538Medicaid