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NPI Code Detail

MEDICARE: MRS. TANYA COOK RN

MEDICARE: MRS. TANYA COOK RN
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
1163W00000XRegistered NurseRN177895GA

General Provider Information

NPI Number : 1477956746
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TANYA COOK RN
Provider Business Mailing Address
First Line : 150 SCRANTON CONNECTOR
Second Line :
City : BRUNSWICK
State : GA
Zip : 31525-0540
Country : US
Telephone Number : 912-264-3961
Fax Number :
Provider Business Practice Location Address
First Line : 2747 4TH ST
Second Line :
City : BRUNSWICK
State : GA
Zip : 31520-3714
Country : US
Telephone Number : 912-264-3961
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/01/2014
Last Update Date : 10/01/2014

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Directions to “ MRS. TANYA COOK RN” Practice Location

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