Provider Demographics
NPI:1265529929
Name:COOK, GINGER M (APRN)
Entity type:Individual
Prefix:
First Name:GINGER
Middle Name:M
Last Name:COOK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 HOSPITAL DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CARTHAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37030-4004
Mailing Address - Country:US
Mailing Address - Phone:615-735-3450
Mailing Address - Fax:615-735-3460
Practice Address - Street 1:133 HOSPITAL DR
Practice Address - Street 2:SUITE 200
Practice Address - City:CARTHAGE
Practice Address - State:TN
Practice Address - Zip Code:37030-4004
Practice Address - Country:US
Practice Address - Phone:615-735-3450
Practice Address - Fax:615-735-3460
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6473363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3905471Medicare ID - Type Unspecified
TNR62041Medicare UPIN