Provider Demographics
NPI:1376288241
Name:COOKE, ALEXANDRA (APRN)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:COOKE
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 1:187 HICKMAN ST
Mailing Address - Street 2:
Mailing Address - City:SODDY DAISY
Mailing Address - State:TN
Mailing Address - Zip Code:37379-6932
Mailing Address - Country:US
Mailing Address - Phone:423-260-5437
Mailing Address - Fax:
Practice Address - Street 1:1970 JORDAN AVE NW
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37311-1900
Practice Address - Country:US
Practice Address - Phone:423-790-7662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-04
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN31610363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily