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General NPI Number Information
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NPI Number | 1063696425
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Entity Type | Individual
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Provider Name | GINA MARIE COOK FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 12/20/2007
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Last Update Date | 04/12/2022
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Provider Practice Location Address
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Address Line | 601 W RIVERSIDE DR STE 4
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City | PARKER
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State | AZ
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Zip | 85344-5119
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Country | US
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Telephone | 928-256-4110
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Fax | 928-722-6113
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Provider Business Mailing Address
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Address Line | PO BOX 617
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City | SOMERTON
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State | AZ
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Zip | 85350-0617
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Country | US
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Telephone | 928-315-7910
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Fax | 289-722-6113
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R28493
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License Number State | ND
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 247215
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | R28492
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License Number State | ND
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Taxonomy #4
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 247215
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License Number State | AZ
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