Provider Demographics
NPI:1457790966
Name:COOK, ROXANNE J (RN)
Entity Type:Individual
Prefix:
First Name:ROXANNE
Middle Name:J
Last Name:COOK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1183 JACKS RUN ROAD
Mailing Address - Street 2:
Mailing Address - City:NORTH VERSAILLES
Mailing Address - State:PA
Mailing Address - Zip Code:15137
Mailing Address - Country:US
Mailing Address - Phone:412-349-6708
Mailing Address - Fax:412-349-6716
Practice Address - Street 1:1183 JACKS RUN ROAD
Practice Address - Street 2:
Practice Address - City:NORTH VERSAILLES
Practice Address - State:PA
Practice Address - Zip Code:15137
Practice Address - Country:US
Practice Address - Phone:412-346-6708
Practice Address - Fax:412-346-6716
Is Sole Proprietor?:No
Enumeration Date:2013-06-18
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN309728L163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics