Healthcare Provider Details

I. General information

NPI: 1487025680
Provider Name (Legal Business Name): KIM M. COOK C.P.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KIM M AMUNDSEN

II. Dates (important events)

Enumeration Date: 10/13/2015
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 HUNTERS TRAIL
GETTYSBURG PA
17325-7281
US

IV. Provider business mailing address

11 HUNTERS TRAIL
GETTYSBURG PA
17325-7281
US

V. Phone/Fax

Practice location:
  • Phone: 717-334-7681
  • Fax: 717-334-0730
Mailing address:
  • Phone: 210-281-8669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberSP025786
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAP129341
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: