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General NPI Number Information
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NPI Number | 1750846424
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Entity Type | Individual
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Provider Name | SAMANTHA D COOK NP-C
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Gender | Female
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Dates
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Enumeration Date | 02/06/2019
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Last Update Date | 07/06/2025
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Provider Practice Location Address
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Address Line | 230 CHERRY ST
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City | CHILLICOTHEE
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State | OH
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Zip | 45601-2301
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Country | US
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Telephone | 220-666-0507
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Fax | 220-666-0507
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Provider Business Mailing Address
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Address Line | 11553 US HIGHWAY 52
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City | STOUT
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State | OH
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Zip | 45684-9649
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Country | US
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Telephone | 740-285-2279
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Fax | 220-666-0507
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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 | 3013129
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 024145
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1197024
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License Number State | TX
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