Provider Demographics
NPI:1922077296
Name:COOKE, ERMA MARIE II (NNP - BC)
Entity Type:Individual
Prefix:
First Name:ERMA
Middle Name:MARIE
Last Name:COOKE
Suffix:II
Gender:F
Credentials:NNP - BC
Other - Prefix:
Other - First Name:ERMA
Other - Middle Name:M
Other - Last Name:COOKE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NNP-BC
Mailing Address - Street 1:PO BOX 602373
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2373
Mailing Address - Country:US
Mailing Address - Phone:828-250-2833
Mailing Address - Fax:828-651-6559
Practice Address - Street 1:509 BILTMORE AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4601
Practice Address - Country:US
Practice Address - Phone:828-213-8600
Practice Address - Fax:828-213-8680
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC266373363L00000X, 363LN0000X, 363LN0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNCH605AMedicare PIN