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Individual

THEIL L COOKE JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
APRN

Contact information

Practice address
1070 N HILDALE ST # 750, HILDALE, UT 84784-7770
(352) 165-4884
(435) 216-5969
Mailing address
340 W HARKER AVE # 750, COLORADO CITY, AZ 86021-6198
(928) 377-0629
(435) 216-5969

Taxonomy

Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
RN178632
AZ
363LF0000X
Family Nurse Practitioner
233616
AZ
363LF0000X
Family Nurse Practitioner
Primary
8273152-8900
UT

Other

Enumeration date
10/04/2019
Last updated
02/01/2023
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