Individual
MS. ANNA M COOK
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
370 CLINE AVE, MANSFIELD, OH 44907-1057
(419) 756-0011
(419) 756-9279
Mailing address
370 CLINE AVE, MANSFIELD, OH 44907-1057
(419) 756-0011
(419) 756-9279
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
50001210
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1039089
NCCPA ID NUMBER
—
01
—
50-00-1210
STATE PHYS. ASSIST. REG.#
OH
Enumeration date
03/15/2006
Last updated
07/08/2007
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