Provider Demographics
NPI:1629394507
Name:COOK, MICHELLE SEAMSTER (FNP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:SEAMSTER
Last Name:COOK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 528
Mailing Address - Street 2:12522 W COLONIAL TRAIL HWY
Mailing Address - City:CREWE
Mailing Address - State:VA
Mailing Address - Zip Code:23930-0528
Mailing Address - Country:US
Mailing Address - Phone:434-645-9191
Mailing Address - Fax:434-645-1859
Practice Address - Street 1:12522 W COLONIAL TRAIL HWY
Practice Address - Street 2:
Practice Address - City:CREWE
Practice Address - State:VA
Practice Address - Zip Code:23930-0528
Practice Address - Country:US
Practice Address - Phone:434-645-9191
Practice Address - Fax:434-645-1859
Is Sole Proprietor?:No
Enumeration Date:2010-04-16
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024164973363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily