Provider Demographics
NPI:1790479103
Name:COOK, LINDSEY ANN
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:ANN
Last Name:COOK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 CLOQUET AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:CLOQUET
Mailing Address - State:MN
Mailing Address - Zip Code:55720-1660
Mailing Address - Country:US
Mailing Address - Phone:218-879-2035
Mailing Address - Fax:
Practice Address - Street 1:807 CLOQUET AVE STE 200
Practice Address - Street 2:
Practice Address - City:CLOQUET
Practice Address - State:MN
Practice Address - Zip Code:55720-1660
Practice Address - Country:US
Practice Address - Phone:218-879-2035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-07
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1978872163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health