Provider Demographics
NPI:1295192672
Name:COOK, CHRISTOPHER SHAWN (CNP)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:SHAWN
Last Name:COOK
Suffix:
Gender:M
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 NW 194TH CIR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73012-3551
Mailing Address - Country:US
Mailing Address - Phone:405-558-1006
Mailing Address - Fax:
Practice Address - Street 1:1805 NW 194TH CIR
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73012-3551
Practice Address - Country:US
Practice Address - Phone:405-558-1006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-15
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK85525363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily