Provider Demographics
NPI:1659905016
Name:COOK, ERIKA (RD)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:COOK
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:ERIKA
Other - Middle Name:LYNN
Other - Last Name:BAUERBAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7 SEA OAKS DR
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32080-7914
Mailing Address - Country:US
Mailing Address - Phone:904-894-1592
Mailing Address - Fax:
Practice Address - Street 1:7 SEA OAKS DR
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32080-7914
Practice Address - Country:US
Practice Address - Phone:904-894-1592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-25
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND7072133VN1201X, 133VN1005X, 133VN1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight Management
No133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal
No133VN1301XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Oncology