Healthcare Provider Details

I. General information

NPI: 1568494243
Provider Name (Legal Business Name): MELISSA R COOK NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 05/09/2024
Certification Date: 05/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5511 VIRGINIA WAY STE 300
BRENTWOOD TN
37027-7611
US

IV. Provider business mailing address

5511 VIRGINIA WAY STE 300
BRENTWOOD TN
37027-7611
US

V. Phone/Fax

Practice location:
  • Phone: 615-994-1000
  • Fax: 615-994-0100
Mailing address:
  • Phone: 615-994-1000
  • Fax: 615-994-0100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11393
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: