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NPI Code Detail

MEDICARE: ERMA MARIE COOKE II NNP - BC

MEDICARE: ERMA MARIE COOKE II NNP - BC
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
1363LN0000XNeonatal Nurse Practitioner5006748NC

General Provider Information

NPI Number : 1922077296
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERMA MARIE COOKE II NNP - BC
Provider Business Mailing Address
First Line : 360 PARKWOOD MEDICAL PARK
Second Line :
City : ELKIN
State : NC
Zip : 28621-2444
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 180 PARKWOOD DR
Second Line :
City : ELKIN
State : NC
Zip : 28621-2430
Country : US
Telephone Number : 336-527-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2006
Last Update Date : 09/25/2025

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