Individual
MRS. MISTY G COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
1724 KENTON ST STE 2B, HOPKINSVILLE, KY 42240-1981
(270) 632-4555
Mailing address
900 HOSPITAL DR, MADISONVILLE, KY 42431-1644
(270) 825-5100
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
3006628
KY
363LA2100X
Acute Care Nurse Practitioner
6628P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000757773
ANTHEM BCBS- TROVER CLINIC
KY
05
—
7100193430
—
KY
01
—
P01114079
MEDICARE RR
KY
Enumeration date
09/14/2010
Last updated
07/21/2022
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