Healthcare Provider Details

I. General information

NPI: 1245980044
Provider Name (Legal Business Name): COLLETTE COOK DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2022
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 TOWER BLVD STE 1605
DURHAM NC
27707-2574
US

IV. Provider business mailing address

3100 TOWER BLVD STE 1605
DURHAM NC
27707-2574
US

V. Phone/Fax

Practice location:
  • Phone: 919-428-5864
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2026-00148
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: