Healthcare Provider Details

I. General information

NPI: 1376993428
Provider Name (Legal Business Name): ALLISON COOK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2016
Last Update Date: 05/30/2025
Certification Date: 05/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8300 CARMEL AVE NE STE 401
ALBUQUERQUE NM
87122-3147
US

IV. Provider business mailing address

5808 VALERIAN PL NE
ALBUQUERQUE NM
87111-8121
US

V. Phone/Fax

Practice location:
  • Phone: 505-321-4819
  • Fax:
Mailing address:
  • Phone: 616-617-0131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301110006
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4351037574
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberMD2019-0518
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: