Healthcare Provider Details

I. General information

NPI: 1083586853
Provider Name (Legal Business Name): TAMARA LYN COOK FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2025
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1407 SE WASHINGTON BLVD
BARTLESVILLE OK
74006-4541
US

IV. Provider business mailing address

209 SE GREYSTONE AVE
BARTLESVILLE OK
74006-2610
US

V. Phone/Fax

Practice location:
  • Phone: 918-335-2273
  • Fax:
Mailing address:
  • Phone: 405-701-3140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberTMP-163160
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: