Provider Demographics
NPI:1336108448
Name:COOKSEY, KAREN PAULA (APRN)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:PAULA
Last Name:COOKSEY
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 1:11685 ALPHARETTA HWY STE 270
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-4982
Mailing Address - Country:US
Mailing Address - Phone:770-619-5100
Mailing Address - Fax:404-250-8067
Practice Address - Street 1:11685 ALPHARETTA HWY STE 270
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-4982
Practice Address - Country:US
Practice Address - Phone:770-410-4610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN084993363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA50BBKDNMedicare UPIN