Healthcare Provider Details

I. General information

NPI: 1720340029
Provider Name (Legal Business Name): CHERYL COOK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2012
Last Update Date: 03/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1424 HAMPSHIRE WEST CT APT 5
SILVER SPRING MD
20903-2527
US

IV. Provider business mailing address

1416 9TH ST NW
WASHINGTON DC
20001-3344
US

V. Phone/Fax

Practice location:
  • Phone: 240-883-4889
  • Fax:
Mailing address:
  • Phone: 202-483-9111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: