Provider Demographics
NPI:1558537753
Name:COOK, NATALIE JEAN (PA)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:JEAN
Last Name:COOK
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7200
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-0200
Mailing Address - Country:US
Mailing Address - Phone:252-937-0200
Mailing Address - Fax:
Practice Address - Street 1:100 DODD ST
Practice Address - Street 2:
Practice Address - City:SPRING HOPE
Practice Address - State:NC
Practice Address - Zip Code:27882-9348
Practice Address - Country:US
Practice Address - Phone:252-478-5412
Practice Address - Fax:252-937-3100
Is Sole Proprietor?:No
Enumeration Date:2008-05-07
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5601002689363A00000X
VA0110003183363A00000X
NC0010-11488363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant