Healthcare Provider Details

I. General information

NPI: 1154285278
Provider Name (Legal Business Name): SARAH COOK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 E 38TH ST
MARION IN
46953-4568
US

IV. Provider business mailing address

4807 MIAMI BEND RD
LOGANSPORT IN
46947-4113
US

V. Phone/Fax

Practice location:
  • Phone: 765-674-3321
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28157556A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: