Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | E-9453 | AR |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | E-9453 | AR |
N | 207R00000X | Internist | A102273 | CA |
N | 111NI0900X | Internist | A102273 | CA |
NPI | 1497923445 |
---|---|
Provider Name | Dr. Kathlyn R. Cook |
First Address | Lowell, AR 72745-0550 |
Second Address | Fayetteville, AR 72703-4424 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2008 |
Last Update Date | 13/09/2017 |