Individual
ALICE JENNETTE COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3333 SILAS CREEK PKWY, WINSTON SALEM, NC 27103-3013
(336) 718-7041
(336) 718-9622
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(336) 718-7041
(336) 718-9622
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
0001100660
VA
363L00000X
Nurse Practitioner
Primary
5004295
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010216761
—
VA
Enumeration date
07/26/2006
Last updated
04/12/2021
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