Healthcare Provider Details

I. General information

NPI: 1700394889
Provider Name (Legal Business Name): RHONDA ANN COOK NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RHONDA AVERY

II. Dates (important events)

Enumeration Date: 01/11/2018
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3699 CASCADE RD SW STE B2
ATLANTA GA
30331-2163
US

IV. Provider business mailing address

4181 HOSPITAL DR NE STE 10
COVINGTON GA
30014-2541
US

V. Phone/Fax

Practice location:
  • Phone: 404-691-7006
  • Fax:
Mailing address:
  • Phone: 770-385-8954
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberRN219261
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN-NP219261
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: