Healthcare Provider Details

I. General information

NPI: 1477959179
Provider Name (Legal Business Name): ELAINE COOK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2014
Last Update Date: 02/04/2026
Certification Date: 02/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 DESALES AVE
CHATTANOOGA TN
37404-1161
US

IV. Provider business mailing address

4812 MONTCREST CIR
CHATTANOOGA TN
37416-1213
US

V. Phone/Fax

Practice location:
  • Phone: 423-495-2525
  • Fax: 423-495-6312
Mailing address:
  • Phone: 423-344-5658
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number3801
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number19599
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: