Provider Demographics
NPI:1376508069
Name:COOK, KAREN A (APN)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:A
Last Name:COOK
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 US HIGHWAY 46
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MINE HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:07803-3163
Mailing Address - Country:US
Mailing Address - Phone:973-328-1040
Mailing Address - Fax:973-328-1544
Practice Address - Street 1:195 US HIGHWAY 46
Practice Address - Street 2:SUITE 200
Practice Address - City:MINE HILL
Practice Address - State:NJ
Practice Address - Zip Code:07803-3163
Practice Address - Country:US
Practice Address - Phone:973-328-1040
Practice Address - Fax:973-328-1544
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN08246600363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8406308Medicaid
NJ8406308Medicaid
NJP10407Medicare UPIN