Provider Demographics
NPI:1619182904
Name:COOKS, MELISSA A (CRNP)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:A
Last Name:COOKS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5782 DUNSTER COURT
Mailing Address - Street 2:#271
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22311
Mailing Address - Country:US
Mailing Address - Phone:216-288-2944
Mailing Address - Fax:
Practice Address - Street 1:111 MICHIGAN AVENUE
Practice Address - Street 2:NEONATOLOGY DEPARTMENT
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010
Practice Address - Country:US
Practice Address - Phone:202-884-5040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1009148363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal