Provider Demographics
NPI:1265787774
Name:COOK, KRISTA MCCOY WARNER (PA-C)
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:MCCOY WARNER
Last Name:COOK
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:988102 NEBRASKA MEDICAL CTR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68198-8102
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2500 BELLEVUE MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68123-1591
Practice Address - Country:US
Practice Address - Phone:402-763-3035
Practice Address - Fax:402-763-3194
Is Sole Proprietor?:No
Enumeration Date:2012-07-20
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMA058810363A00000X
NE2159363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant