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General NPI Number Information
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NPI Number | 1063864163
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Entity Type | Individual
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Provider Name | ELIZABETH ANN COOK PHARMD
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Gender | Female
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Dates
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Enumeration Date | 07/13/2016
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Last Update Date | 11/27/2020
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Provider Practice Location Address
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Address Line | 5500 E KELLOGG DR
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City | WICHITA
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State | KS
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Zip | 67218-1607
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Country | US
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Telephone | 316-685-2221
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Fax |
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Provider Business Mailing Address
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Address Line | 5211 S HARVARD AVE APT H
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City | TULSA
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State | OK
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Zip | 74135-3580
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Country | US
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Telephone | 607-321-5042
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Fax |
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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 | 1835P2201X
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Taxonomy Name | Ambulatory Care Pharmacist
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License Number | 1-16877
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License Number State | KS
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