Individual
DEBRA SUSAN COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
750 BROADWAY AVE E, MATTOON, IL 61938-4610
(217) 238-5700
(217) 238-5767
Mailing address
3115 LOREN LN, CHARLESTON, IL 61920-4417
(217) 348-5312
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
41191239
IL
163W00000X
Registered Nurse
R20024
NM
Other
Enumeration date
10/23/2006
Last updated
11/16/2007
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