Provider Demographics
NPI:1619288693
Name:COOK, ROBIN EDWARD (CRNA)
Entity Type:Individual
Prefix:MR
First Name:ROBIN
Middle Name:EDWARD
Last Name:COOK
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1209 N HARVEY AVE APT 303
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73103-3729
Mailing Address - Country:US
Mailing Address - Phone:405-209-8058
Mailing Address - Fax:
Practice Address - Street 1:1209 N HARVEY AVE APT 303
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73103-3729
Practice Address - Country:US
Practice Address - Phone:405-209-8058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-24
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK67576367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered