Provider Demographics
NPI:1972156057
Name:COOK, KRISTEN LYNN (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:LYNN
Last Name:COOK
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 MCDONALD AVE
Mailing Address - Street 2:
Mailing Address - City:CUTHBERT
Mailing Address - State:GA
Mailing Address - Zip Code:39840-5829
Mailing Address - Country:US
Mailing Address - Phone:229-732-3721
Mailing Address - Fax:229-732-6536
Practice Address - Street 1:125 MCDONALD AVE
Practice Address - Street 2:
Practice Address - City:CUTHBERT
Practice Address - State:GA
Practice Address - Zip Code:39840-5829
Practice Address - Country:US
Practice Address - Phone:229-732-3721
Practice Address - Fax:229-732-6536
Is Sole Proprietor?:No
Enumeration Date:2019-07-18
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN216267363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily