=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356276661
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DONNISHA R COOK MS, RDN, LDN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/17/2026
-----------------------------------------------------
Last Update Date | 06/17/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2301 ERWIN RD
-----------------------------------------------------
City | DURHAM
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27705-4699
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 919-684-8111
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8857 THORNTON TOWN PL
-----------------------------------------------------
City | RALEIGH
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27616-8065
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 919-396-3217
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 133V00000X
-----------------------------------------------------
Taxonomy Name | Registered Dietitian
-----------------------------------------------------
License Number | L009301
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------