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Individual

MRS. NICOLE MARIA COOKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP-BC

Contact information

Practice address
5964 US HIGHWAY 90, LIVE OAK, FL 32060-8694
(631) 388-3933
Mailing address
5964 US HIGHWAY 90, LIVE OAK, FL 32060-8694
(386) 963-6530

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11013322
FL
390200000X
Student in an Organized Health Care Education/Training Program
9435338
FL

Other

Enumeration date
10/22/2020
Last updated
05/26/2021
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