Provider Demographics
NPI:1386646875
Name:COOK, JULIET (CRNP)
Entity Type:Individual
Prefix:
First Name:JULIET
Middle Name:
Last Name:COOK
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 E PENNSYLVANIA AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-2602
Mailing Address - Country:US
Mailing Address - Phone:610-280-7960
Mailing Address - Fax:610-280-7962
Practice Address - Street 1:150 E PENNSYLVANIA AVE STE 200
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-2602
Practice Address - Country:US
Practice Address - Phone:610-280-7960
Practice Address - Fax:610-280-7962
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP004921B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAS63701Medicare UPIN
PA018351Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER