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Individual

DOUGLAS G COOK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP

Contact information

Practice address
2355 N WYATT DR, SUITE 101, TUCSON, AZ 85712-2120
(520) 616-4948
(520) 616-4958
Mailing address
PO BOX 188, MARANA, AZ 85653-0188
(520) 682-4111
(520) 818-3630

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP4567
AZ
363LF0000X
Family Nurse Practitioner
TAP4567
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
724660
AZ
Enumeration date
07/23/2012
Last updated
07/20/2015
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