Individual
COLEENE GWENETH COOKE
Active
Individual
COLEENE GWENETH COOKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
37000
IA
2085R0202X
Diagnostic Radiology Physician
48169-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0735951
—
IA
05
—
17335951
—
IA
05
—
2735951
—
IA
01
—
30009
WELLMARK FINLEY LOCATION
IA
01
—
30011
WELLMARK OFFICE LOCATION
IA
01
—
30020
WELLMARK MAQUOKETA LOCAT
IA
05
—
34754700
—
WI
Enumeration date
07/03/2006
Last updated
02/01/2008
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