Provider Demographics
NPI:1922012020
Name:COOKS, FELICIA M (CRNA)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:M
Last Name:COOKS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:FELICIA
Other - Middle Name:M
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:907 VALLEY CT
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76013-1450
Mailing Address - Country:US
Mailing Address - Phone:817-793-7213
Mailing Address - Fax:817-299-0036
Practice Address - Street 1:907 VALLEY CT
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013-1450
Practice Address - Country:US
Practice Address - Phone:817-793-7213
Practice Address - Fax:817-299-0036
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX605457367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX155054302Medicaid