Provider Demographics
NPI:1104476910
Name:COOK, CHRISTINA H
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:H
Last Name:COOK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 FOREST CT
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24540-6105
Mailing Address - Country:US
Mailing Address - Phone:434-203-0687
Mailing Address - Fax:
Practice Address - Street 1:109 FOREST CT
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-6105
Practice Address - Country:US
Practice Address - Phone:434-203-0687
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-13
Last Update Date:2019-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider