Healthcare Provider Details

I. General information

NPI: 1972156057
Provider Name (Legal Business Name): KRISTEN LYNN COOK MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2019
Last Update Date: 04/23/2025
Certification Date: 04/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2303 DAWSON RD STE 101
ALBANY GA
31707-2715
US

IV. Provider business mailing address

2303 DAWSON RD STE 101
ALBANY GA
31707-2715
US

V. Phone/Fax

Practice location:
  • Phone: 229-883-1130
  • Fax: 229-883-1153
Mailing address:
  • Phone: 229-883-1130
  • Fax: 229-883-1153

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN216267
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN216267
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: