Healthcare Provider Details

I. General information

NPI: 1942922497
Provider Name (Legal Business Name): BRIELLE AMBER COOK APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2022
Last Update Date: 11/18/2024
Certification Date: 09/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MADISON AVE
MORRISTOWN NJ
07960-6136
US

IV. Provider business mailing address

197 RIDGEDALE AVE. SUITE #225
CEDAR KNOLLS NJ
07927
US

V. Phone/Fax

Practice location:
  • Phone: 973-971-5000
  • Fax:
Mailing address:
  • Phone: 973-524-7055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number26NJ01365800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: