Provider Demographics
NPI:1982974465
Name:COOK, CHRIS (RN)
Entity Type:Individual
Prefix:
First Name:CHRIS
Middle Name:
Last Name:COOK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 HENDY AVE
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14905-1905
Mailing Address - Country:US
Mailing Address - Phone:607-735-3760
Mailing Address - Fax:607-735-3759
Practice Address - Street 1:110 HENDY AVE
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14905
Practice Address - Country:US
Practice Address - Phone:607-735-3760
Practice Address - Fax:607-735-3759
Is Sole Proprietor?:No
Enumeration Date:2011-12-30
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY444003-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool