Healthcare Provider Details

I. General information

NPI: 1558788232
Provider Name (Legal Business Name): ASHLEY COOK FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2014
Last Update Date: 02/17/2021
Certification Date: 02/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4811 AMBASSADOR CAFFERY PKWY STE 305
LAFAYETTE LA
70508-7265
US

IV. Provider business mailing address

4811 AMBASSADOR CAFFERY PKWY STE 305
LAFAYETTE LA
70508-7265
US

V. Phone/Fax

Practice location:
  • Phone: 337-470-3040
  • Fax: 337-470-3052
Mailing address:
  • Phone: 337-470-3040
  • Fax: 337-470-3052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP07642
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: