Provider Demographics
NPI:1356893366
Name:COOKS, SHAUNA FRANICE (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MISS
First Name:SHAUNA
Middle Name:FRANICE
Last Name:COOKS
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 ROBERT T LONGWAY BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-2190
Mailing Address - Country:US
Mailing Address - Phone:810-235-2004
Mailing Address - Fax:
Practice Address - Street 1:2700 ROBERT T LONGWAY BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-2190
Practice Address - Country:US
Practice Address - Phone:810-235-2004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-26
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704231163363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health