Healthcare Provider Details

I. General information

NPI: 1780333773
Provider Name (Legal Business Name): SARAH ROCHELLE COOK BSN, RN, OCN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2022
Last Update Date: 03/18/2022
Certification Date: 03/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11109 PARKVIEW PLAZA DR
FORT WAYNE IN
46845-1701
US

IV. Provider business mailing address

7711 COUNTY ROAD 50
BUTLER IN
46721-9770
US

V. Phone/Fax

Practice location:
  • Phone: 260-266-8274
  • Fax:
Mailing address:
  • Phone: 260-908-6339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License Number28185086A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: