Provider Demographics
NPI:1083586853
Name:COOK, TAMARA LYN (FNP)
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:LYN
Last Name:COOK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 SE GREYSTONE AVE
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74006-2610
Mailing Address - Country:US
Mailing Address - Phone:405-701-3140
Mailing Address - Fax:
Practice Address - Street 1:4601 E DOUGLAS AVE STE 150
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-1032
Practice Address - Country:US
Practice Address - Phone:408-701-3140
Practice Address - Fax:800-886-4642
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-22
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSTMP-163160363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily