Provider Demographics
NPI:1992199210
Name:COOK, HANNAH FRAYNE EMANUEL (RN)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:FRAYNE EMANUEL
Last Name:COOK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:FRAYNE
Other - Last Name:EMANUEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3165 E GREENHURST RD
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-8655
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3165 E GREENHURST RD
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83686-8655
Practice Address - Country:US
Practice Address - Phone:208-461-7833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-25
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDNP-1616A363LF0000X
CO0199705163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO0199705OtherRN LICENSE
IDNP-1616AOtherNP
IDN-50674OtherRN