Individual
CAROLYN COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7150 CLEARVISTA DR, INDIANAPOLIS, IN 46256-1695
(317) 621-5890
Mailing address
PO BOX 5545, LAFAYETTE, IN 47903-5545
(765) 448-8000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28190791A
IN
367500000X
Certified Registered Nurse Anesthetist
Primary
28190791A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000982590
ANTHEM PROVIDER NUMBER
IN
05
—
201336930
—
IN
Enumeration date
06/29/2015
Last updated
08/04/2025
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