Individual
JOHANNA YADIRA COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
736 IRVING AVE, SYRACUSE, NY 13210-1602
(315) 470-7111
Mailing address
1364 W QUEEN ST, HAMPTON, VA 23669-3842
(757) 232-2644
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
0001224821
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN11008593
FL
Other
Enumeration date
03/30/2020
Last updated
07/15/2025
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