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General NPI Number Information
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NPI Number | 1992481543
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Entity Type | Individual
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Provider Name | CORINN RENEE COOK PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/27/2023
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 119 S C ST
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City | MILFORD
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State | NE
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Zip | 68405-1802
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Country | US
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Telephone | 402-761-3307
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Fax | 402-761-3493
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Provider Business Mailing Address
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Address Line | 300 N COLUMBIA AVE
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City | SEWARD
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State | NE
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Zip | 68434-2299
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Country | US
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Telephone | 402-643-4800
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Fax | 402-646-4635
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 3220
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License Number State | NE
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