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General NPI Number Information
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NPI Number | 1144036310
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Entity Type | Individual
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Provider Name | SHAUNNAN ALLEN COOK
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Gender | Female
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Dates
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Enumeration Date | 12/03/2024
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 103 MISTY MORN LN
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City | HUNTSVILLE
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State | AL
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Zip | 35811-8688
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Country | US
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Telephone | 256-604-8613
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Fax |
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Provider Business Mailing Address
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Address Line | 103 MISTY MORN LN
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City | HUNTSVILLE
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State | AL
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Zip | 35811-8688
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Country | US
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Telephone | 256-604-8613
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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 | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | 954
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number | 954
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License Number State | AL
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