Provider Demographics
NPI:1548212210
Name:CODD-COOK, NANCY (FNP, PHD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:
Last Name:CODD-COOK
Suffix:
Gender:F
Credentials:FNP, PHD
Other - Prefix:DR
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP, PHD
Mailing Address - Street 1:PO BOX 725
Mailing Address - Street 2:
Mailing Address - City:COOPERSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13326-0725
Mailing Address - Country:US
Mailing Address - Phone:607-433-1790
Mailing Address - Fax:607-433-6608
Practice Address - Street 1:125 MAIN ST
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820-2531
Practice Address - Country:US
Practice Address - Phone:607-433-1790
Practice Address - Fax:607-433-6608
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF330346363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02289398Medicaid
NY02289398Medicaid
NYR89976Medicare UPIN