Healthcare Provider Details

I. General information

NPI: 1962338319
Provider Name (Legal Business Name): JOSHUA SHANE COOKE FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

88 HOSPITAL DR
SPRUCE PINE NC
28777-8943
US

IV. Provider business mailing address

427 GAGE BRANCH RD
BAKERSVILLE NC
28705-8105
US

V. Phone/Fax

Practice location:
  • Phone: 828-765-6101
  • Fax:
Mailing address:
  • Phone: 828-467-1373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5024726
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: