Healthcare Provider Details

I. General information

NPI: 1831829704
Provider Name (Legal Business Name): MELISSA J COOK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2022
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 CORBY RD
WEST GROVE PA
19390-9420
US

IV. Provider business mailing address

121 CORBY ROAD
WEST GROVE PA
19390
US

V. Phone/Fax

Practice location:
  • Phone: 610-235-7133
  • Fax:
Mailing address:
  • Phone: 610-235-7133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: