Provider Demographics
NPI:1265919708
Name:COOK, SARAH JOY (APRN)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:JOY
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 1:64 LETTA DR
Mailing Address - Street 2:
Mailing Address - City:POTTSVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72858-5000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:291 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LAMAR
Practice Address - State:AR
Practice Address - Zip Code:72846
Practice Address - Country:US
Practice Address - Phone:870-895-2015
Practice Address - Fax:870-895-2164
Is Sole Proprietor?:No
Enumeration Date:2018-07-27
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA005788363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily