Provider Demographics
NPI:1760651988
Name:COOK, BARBARA ANITA (CNS)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANITA
Last Name:COOK
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8890 N UNION BLVD
Mailing Address - Street 2:STE 160
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-7799
Mailing Address - Country:US
Mailing Address - Phone:719-365-9950
Mailing Address - Fax:719-365-9969
Practice Address - Street 1:175 S UNION BLVD
Practice Address - Street 2:STE 300
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80910-3113
Practice Address - Country:US
Practice Address - Phone:719-365-6363
Practice Address - Fax:719-365-5801
Is Sole Proprietor?:No
Enumeration Date:2008-02-21
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO83913364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO5857856Medicaid
COCO306709Medicare PIN
CO259859YLB8Medicare PIN