Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 3621 | SC |
NPI | 1003078262 |
---|---|
Provider Name | Barbara Ann Cook |
First Address | Columbia, SC 29206-3104 |
Second Address | Sumter, SC 29150-1820 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2008 |
Last Update Date | 30/06/2008 |