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General NPI Number Information
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NPI Number | 1124577887
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Entity Type | Individual
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Provider Name | HEIDI H COOK APRN
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Gender | Female
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Dates
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Enumeration Date | 09/22/2016
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 621 W LUMSDEN RD
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City | BRANDON
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State | FL
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Zip | 33511-5911
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Country | US
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Telephone | 813-755-3500
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Fax | 813-755-3300
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Provider Business Mailing Address
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Address Line | 1622 TALL PINES TRL
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City | LAKELAND
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State | FL
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Zip | 33810-0186
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Country | US
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Telephone |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 9165104
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License Number State | FL
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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 | APRN9165104
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License Number State | FL
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