Individual
MRS. CAROL A COOKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
6438 WILMINGTON PIKE, SUITE 300, CENTERVILLE, OH 45459
(937) 848-4850
(937) 848-4858
Mailing address
6438 WILMINGTON PIKE STE 300, CENTERVILLE, OH 45459-7021
(937) 848-4850
(937) 848-4858
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
RN212344
OH
363LF0000X
Family Nurse Practitioner
Primary
COA05642NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0074036
—
OH
01
—
COA05642NP
LICENSE NP
OH
01
—
RX05642
CERTIFICATE TO PRESCRIBE
OH
Enumeration date
05/01/2008
Last updated
01/28/2021
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