Provider Demographics
NPI:1437757960
Name:COOK, STEPHANIE H (NP)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:H
Last Name:COOK
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:2901 TELESTAR CT STE 300
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-1263
Mailing Address - Country:US
Mailing Address - Phone:703-591-1688
Mailing Address - Fax:703-591-1445
Practice Address - Street 1:4825 MARK CENTER DR STE 150
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22311-1846
Practice Address - Country:US
Practice Address - Phone:703-751-8111
Practice Address - Fax:703-751-1105
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-16
Last Update Date:2022-08-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0024181204363LA2200X, 363L00000X
TNAG10200024363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health