Provider Demographics
NPI:1629699251
Name:COOK, DARCY RENEE (NP)
Entity Type:Individual
Prefix:
First Name:DARCY
Middle Name:RENEE
Last Name:COOK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:DARCY
Other - Middle Name:RENEE
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:426 HWY 16
Mailing Address - Street 2:
Mailing Address - City:EMMETT
Mailing Address - State:ID
Mailing Address - Zip Code:83617
Mailing Address - Country:US
Mailing Address - Phone:208-365-2735
Mailing Address - Fax:208-365-2737
Practice Address - Street 1:426 HWY 16
Practice Address - Street 2:
Practice Address - City:EMMETT
Practice Address - State:ID
Practice Address - Zip Code:83617
Practice Address - Country:US
Practice Address - Phone:208-365-2735
Practice Address - Fax:208-365-2737
Is Sole Proprietor?:No
Enumeration Date:2020-05-05
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID63078363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily