Individual
ANTRANETTE COOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
490 CENTRE LAKE DR NE STE 200, PALM BAY, FL 32907-1189
(321) 821-4950
(321) 821-4955
Mailing address
1005 BOWSPRIT AVE NW, PALM BAY, FL 32907-9485
(321) 501-6125
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
APRN11024510
FL
363LF0000X
Family Nurse Practitioner
Primary
11024510
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202248493
—
FL
Enumeration date
02/10/2023
Last updated
08/17/2023
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