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General NPI Number Information
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NPI Number | 1508823899
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Entity Type | Individual
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Provider Name | CORRIE L CROOK NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 04/28/2006
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 243 DOVER RD
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City | CLARKSVILLE
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State | TN
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Zip | 37042-4155
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Country | US
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Telephone | 931-905-4646
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Fax |
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Provider Business Mailing Address
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Address Line | 304 BENTWOOD LN
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City | COLUMBIA
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State | SC
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Zip | 29229-8980
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Country | US
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Telephone | 757-870-1008
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024166934
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 18084
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 3008191
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 28467
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License Number State | SC
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