MEDICARE: MRS. DENISE CUELLAR COOK NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	862034	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083324875
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DENISE CUELLAR COOK NP

Provider Business Mailing Address
First Line	:	10141 DRIFTWOOD ESTATE ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89141-8789
Country	:	US
Telephone Number	:	714-322-0145
Fax Number	:

Provider Business Practice Location Address
First Line	:	1090 E DESERT INN RD STE 200
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-2803
Country	:	US
Telephone Number	:	702-657-3873
Fax Number	:	702-636-0787

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/02/2022
Last Update Date	:	02/20/2024

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