Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife |
NPI | 1053755371 |
---|---|
Provider Name | Susan Smartt Cook |
First Address | Edmond, OK 73034-7920 |
Second Address | Edmond, OK 73034-7920 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2013 |
Last Update Date | 18/04/2013 |