Provider Demographics
NPI:1467018325
Name:COOK, KELLY (AUD)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:
Last Name:COOK
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1228 SUNSET DR STE B
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:IA
Mailing Address - Zip Code:50211-2401
Mailing Address - Country:US
Mailing Address - Phone:515-981-9893
Mailing Address - Fax:515-981-9421
Practice Address - Street 1:1228 SUNSET DR STE B
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:IA
Practice Address - Zip Code:50211-2401
Practice Address - Country:US
Practice Address - Phone:515-981-9893
Practice Address - Fax:515-981-9421
Is Sole Proprietor?:No
Enumeration Date:2019-05-16
Last Update Date:2021-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
231H00000X
IA231HA2400X, 231HA2500X, 237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
No231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Supplier
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter