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General NPI Number Information
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NPI Number | 1417219080
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Entity Type | Individual
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Provider Name | CHRISTOPHER ANDREW COOK DNP,CPNP-PC
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Gender | Male
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Dates
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Enumeration Date | 06/11/2012
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Last Update Date | 06/11/2012
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Provider Practice Location Address
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Address Line | 9071 S 1300 W #301
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City | WEST JORDAN
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State | UT
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Zip | 84088-6672
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Country | US
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Telephone | 801-565-1162
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Fax |
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Provider Business Mailing Address
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Address Line | 1106 E SLEEPY HOLLOW LN
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City | SANDY
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State | UT
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Zip | 84094-3728
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 5991761-4405
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License Number State | UT
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