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NPI Code Detail

MEDICARE: MRS. EMALENE C COOK RN NP

MEDICARE:  MRS. EMALENE C COOK  RN 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
1363L00000XNurse Practitioner0024056437VA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2500001603OTHERVAMEDICARE RAILROAD

Other Identifiers

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

General Provider Information

NPI Number : 1194711473
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. EMALENE C COOK RN NP
Provider Business Mailing Address
First Line : PO BOX 810
Second Line :
City : CEDAR BLUFF
State : VA
Zip : 24609-0810
Country : US
Telephone Number : 276-964-6702
Fax Number : 276-964-5669
Provider Business Practice Location Address
First Line : 113 CUMBERLAND ROAD
Second Line :
City : CEDAR BLUFF
State : VA
Zip : 24609
Country : US
Telephone Number : 276-964-6702
Fax Number : 276-964-5669
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2005
Last Update Date : 03/03/2009

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Directions to “ MRS. EMALENE C COOK RN NP” Practice Location

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