Provider Demographics
NPI:1407288459
Name:COOK, CHARLES DAVID (DNP)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:DAVID
Last Name:COOK
Suffix:
Gender:M
Credentials:DNP
Other - Prefix:
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Mailing Address - Street 1:150 CHARLOIS BLVD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-1549
Mailing Address - Country:US
Mailing Address - Phone:336-865-0344
Mailing Address - Fax:336-765-7306
Practice Address - Street 1:150 CHARLOIS BLVD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-1549
Practice Address - Country:US
Practice Address - Phone:336-865-0344
Practice Address - Fax:336-765-7306
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-01
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC5006328363L00000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care