Provider Demographics
NPI:1023469913
Name:COOK, DANIELLE VASQUEZ (APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:VASQUEZ
Last Name:COOK
Suffix:
Gender:F
Credentials: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 1:691 EVANGELINE RD
Mailing Address - Street 2:
Mailing Address - City:MONTZ
Mailing Address - State:LA
Mailing Address - Zip Code:70068-8927
Mailing Address - Country:US
Mailing Address - Phone:504-909-3089
Mailing Address - Fax:
Practice Address - Street 1:1514 JEFFERSON HWY
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70121-2429
Practice Address - Country:US
Practice Address - Phone:504-842-7518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-22
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP08676363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS07954044Medicaid
LA2431498Medicaid
MS07954044Medicaid