Provider Demographics
NPI:1770009656
Name:COOK, BRITTNI SIOUX (FNP-BC)
Entity Type:Individual
Prefix:
First Name:BRITTNI
Middle Name:SIOUX
Last Name:COOK
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:BRITTNI
Other - Middle Name:SIOUX
Other - Last Name:PEDERSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:201 W LAYTON PKWY # 1A
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-3692
Mailing Address - Country:US
Mailing Address - Phone:801-543-6950
Mailing Address - Fax:
Practice Address - Street 1:1154 N 600 W
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:UT
Practice Address - Zip Code:84015-9433
Practice Address - Country:US
Practice Address - Phone:801-837-8307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-22
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT78582224405363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner