Provider Demographics
NPI:1306365747
Name:COOK, WHITNEY ELIZABETH (APRN)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:ELIZABETH
Last Name:COOK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E LIBERTY ST STE 800
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1428
Mailing Address - Country:US
Mailing Address - Phone:502-589-3173
Mailing Address - Fax:502-589-6751
Practice Address - Street 1:201 ABRAHAM FLEXNER WAY STE 1004
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202
Practice Address - Country:US
Practice Address - Phone:502-589-3173
Practice Address - Fax:502-589-6751
Is Sole Proprietor?:No
Enumeration Date:2017-09-18
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3010838363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100538810-KOHMGMedicaid
KYP01922679OtherRR MEDICARE
KYK228840-KOHMGOtherKY MEDICARE
IN300008015A-KOHMGMedicaid