Individual
COURTNEY AMANDA COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
231 E CHESTNUT ST, LOUISVILLE, KY 40202-1821
(502) 629-6000
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6789
(502) 272-5754
(502) 272-5339
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3014308
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300037431
—
IN
01
—
7100659560
KY MEDICAID
KY
01
—
K3000110
KY MEDICARE
KY
Enumeration date
02/13/2020
Last updated
08/26/2024
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