Provider Demographics
NPI:1598524670
Name:COOK, AISHA NICOLE (MHT, CNA)
Entity Type:Individual
Prefix:
First Name:AISHA
Middle Name:NICOLE
Last Name:COOK
Suffix:
Gender:F
Credentials:MHT, CNA
Other - Prefix:
Other - First Name:ISHA
Other - Middle Name:RHYS
Other - Last Name:LORELEI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5559 E 47TH PL APT 418
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-7278
Mailing Address - Country:US
Mailing Address - Phone:918-876-8235
Mailing Address - Fax:
Practice Address - Street 1:2323 S HARVARD AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74114-3301
Practice Address - Country:US
Practice Address - Phone:918-293-2140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist