Provider Demographics
NPI:1851901136
Name:COOK, KELLY FRANCES (APRN)
Entity Type:Individual
Prefix:MS
First Name:KELLY
Middle Name:FRANCES
Last Name:COOK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:KELLY
Other - Middle Name:FRANCES
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:KELLY COOK APRN
Mailing Address - Street 1:824 LLOYD RD
Mailing Address - Street 2:
Mailing Address - City:WICKLIFFE
Mailing Address - State:OH
Mailing Address - Zip Code:44092-2334
Mailing Address - Country:US
Mailing Address - Phone:914-582-1670
Mailing Address - Fax:
Practice Address - Street 1:277 S WASHINGTON ST STE 210
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-3672
Practice Address - Country:US
Practice Address - Phone:571-473-5384
Practice Address - Fax:571-473-5945
Is Sole Proprietor?:No
Enumeration Date:2020-08-03
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.459540163WP0808X
OHAPRN.CNP.0027507363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health