Healthcare Provider Details

I. General information

NPI: 1255421665
Provider Name (Legal Business Name): TERESA LYNN COOK MSN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2006
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

782 WEATHERLY DR
CLARKSVILLE TN
37043-8941
US

IV. Provider business mailing address

3414 SHAGBARK CIR
CLARKSVILLE TN
37043-3827
US

V. Phone/Fax

Practice location:
  • Phone: 931-645-3552
  • Fax: 615-340-2669
Mailing address:
  • Phone: 931-216-5705
  • Fax: 931-208-3552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3011988
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPN7114
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN103725
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: