Provider Demographics
NPI:1376613232
Name:COOK, TERRI SUFFOLETTA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TERRI
Middle Name:SUFFOLETTA
Last Name:COOK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:TERRI
Other - Middle Name:JEAN
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:107 WINDWARD WAY
Mailing Address - Street 2:
Mailing Address - City:NICHOLASVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40356-8000
Mailing Address - Country:US
Mailing Address - Phone:859-619-6714
Mailing Address - Fax:
Practice Address - Street 1:800 ROSE STREET GILL HEART ANTICOAGULATION CLINIC
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-3742
Practice Address - Country:US
Practice Address - Phone:859-323-4998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY013278183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist