Provider Demographics
NPI:1831496926
Name:MERINAR COOK, AUDREY LYNN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:AUDREY
Middle Name:LYNN
Last Name:MERINAR COOK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:AUDREY
Other - Middle Name:LYNN
Other - Last Name:MERINAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1265 GLORY VINE RD
Mailing Address - Street 2:
Mailing Address - City:WHITSETT
Mailing Address - State:NC
Mailing Address - Zip Code:27377-9307
Mailing Address - Country:US
Mailing Address - Phone:304-712-0866
Mailing Address - Fax:
Practice Address - Street 1:101 MANNING DR
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-4220
Practice Address - Country:US
Practice Address - Phone:919-966-4389
Practice Address - Fax:919-966-4389
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-25
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-02561363A00000X
NC168102363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant