Provider Demographics
NPI:1871249870
Name:COOK, JULIE ANN (APRN)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:COOK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 CLEAR SPRINGS TRCE STE 4
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-3868
Mailing Address - Country:US
Mailing Address - Phone:502-356-4377
Mailing Address - Fax:
Practice Address - Street 1:1300 CLEAR SPRINGS TRCE STE 4
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-3868
Practice Address - Country:US
Practice Address - Phone:502-356-4377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-28
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3017068363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily