Provider Demographics
NPI:1801347000
Name:ENDICOTT-COOK, LORI (FNP)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:ENDICOTT-COOK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 HOSPITAL LN
Mailing Address - Street 2:STE 100
Mailing Address - City:DANVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46122-2600
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6620 PARKDALE PL
Practice Address - Street 2:SUITE D
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46254-5620
Practice Address - Country:US
Practice Address - Phone:317-415-7373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-23
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71006761A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily