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General NPI Number Information
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NPI Number | 1134383128
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Entity Type | Individual
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Provider Name | LISA MARII COOKINGHAM MD
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Gender | Female
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Dates
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Enumeration Date | 07/18/2008
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 7920 ACC BLVD STE 300
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City | RALEIGH
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State | NC
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Zip | 27617-8744
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Country | US
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Telephone | 919-908-0000
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Fax | 919-596-6147
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Provider Business Mailing Address
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Address Line | 7920 ACC BLVD STE 300
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City | RALEIGH
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State | NC
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Zip | 27617-8744
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Country | US
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Telephone | 919-908-0000
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Fax | 919-596-6147
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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 | 207VE0102X
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Taxonomy Name | Reproductive Endocrinology Physician
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License Number | 2024-00952
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | MD-40111
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 70191
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 207VE0102X
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Taxonomy Name | Reproductive Endocrinology Physician
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License Number | 83564
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License Number State | SC
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