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NPI Code Detail

MEDICARE: MS. BRIANNE J. COOK P.A.-C

MEDICARE: MS. BRIANNE J. COOK P.A.-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant15-01017KS

General Provider Information

NPI Number : 1407881618
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. BRIANNE J. COOK P.A.-C
Provider Business Mailing Address
First Line : PO BOX 3425
Second Line :
City : LAWRENCE
State : KS
Zip : 66046-0425
Country : US
Telephone Number : 785-830-0100
Fax Number : 785-830-0115
Provider Business Practice Location Address
First Line : 4921 W 18TH ST
Second Line :
City : LAWRENCE
State : KS
Zip : 66047-2090
Country : US
Telephone Number : 785-830-0100
Fax Number : 785-830-0115
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2006
Last Update Date : 09/01/2015

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