Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 006875 | AZ |
NPI | 1003158262 |
---|---|
Provider Name | Dr. Carrie Lynn Cook |
First Address | Phoenix, AZ 85012-1351 |
Second Address | Phoenix, AZ 85006-2612 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2013 |
Last Update Date | 08/04/2021 |