Provider Demographics
NPI:1891769923
Name:COOKE, CYNTHIA C (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:C
Last Name:COOKE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CREDENTIALS COORDINATOR, 4100 GOSS RD
Mailing Address - Street 2:FOX ARMY HEALTH CENTER
Mailing Address - City:REDSTONE ARSENAL
Mailing Address - State:AL
Mailing Address - Zip Code:35898-7000
Mailing Address - Country:US
Mailing Address - Phone:256-955-8888
Mailing Address - Fax:256-313-3260
Practice Address - Street 1:PRIMARY CARE CLINIC 4100 GOSS RD
Practice Address - Street 2:FOX ARMY HEALTH CENTER
Practice Address - City:REDSTONE ARSENAL
Practice Address - State:AL
Practice Address - Zip Code:35809-7000
Practice Address - Country:US
Practice Address - Phone:256-955-8888
Practice Address - Fax:256-313-3260
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-058107363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily