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General NPI Number Information
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NPI Number | 1336547413
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Entity Type | Individual
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Provider Name | LESLIE COOK APRN
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Gender | Female
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Dates
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Enumeration Date | 12/05/2014
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 650 JOEL DR
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City | FORT CAMPBELL
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State | KY
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Zip | 42223-5318
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Country | US
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Telephone | 270-798-8842
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Fax |
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Provider Business Mailing Address
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Address Line | 650 JOEL DR
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City | FORT CAMPBELL
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State | KY
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Zip | 42223-5318
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Country | US
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Telephone | 270-798-8842
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 20820
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 3008762
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 3008762
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number | 3008762
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License Number State | KY
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