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Individual

BRANDY LA-KEYSHA COOK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
3394 MCKELVEY RD STE 102, BRIDGETON, MO 63044-2531
(314) 707-4592
Mailing address
3394 MCKELVEY RD STE 102, BRIDGETON, MO 63044-2531
(314) 707-4582

Taxonomy

Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
F04170189
MO
363LF0000X
Family Nurse Practitioner
Primary
2017014616
MO

Other

Enumeration date
12/06/2017
Last updated
04/15/2025
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