1427240290 NPI number — HEATHER L. COOK APRN FNP

Table of content: HEATHER L. COOK APRN FNP (NPI 1427240290)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427240290 NPI number — HEATHER L. COOK APRN FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COOK
Provider First Name:
HEATHER
Provider Middle Name:
L.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APRN FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
COOK
Provider Other First Name:
HEATHER
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
APRN FNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1427240290
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/10/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
257 BILTMORE AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ASHEVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28801-4120
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-285-0622
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14355 MIRANDA WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOS ALTOS HILLS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94022-2032
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-381-9829
Provider Business Practice Location Address Fax Number:
888-732-8119
Provider Enumeration Date:
08/15/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  110619 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 110619 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 5007631 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 47037660425 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".