Provider Demographics
NPI:1841062312
Name:MCCOOK, SASHA-GAE (APRN)
Entity type:Individual
Prefix:
First Name:SASHA-GAE
Middle Name:
Last Name:MCCOOK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:SASHA-GAE
Other - Middle Name:
Other - Last Name:WEBB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:15412 FIRE ROCK PL
Mailing Address - Street 2:
Mailing Address - City:RUSKIN
Mailing Address - State:FL
Mailing Address - Zip Code:33573-0196
Mailing Address - Country:US
Mailing Address - Phone:727-470-4042
Mailing Address - Fax:
Practice Address - Street 1:3 TAMPA GENERAL CIR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-3571
Practice Address - Country:US
Practice Address - Phone:813-844-7585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9386380163W00000X
FLAPRN11026211363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse