1578843595 NPI number — MS. ELIZABETH KYLE COOK MSN NNP-BC

Table of content: MS. ELIZABETH KYLE COOK MSN NNP-BC (NPI 1578843595)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578843595 NPI number — MS. ELIZABETH KYLE COOK MSN NNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COOK
Provider First Name:
ELIZABETH
Provider Middle Name:
KYLE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MSN NNP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1578843595
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/06/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7736 NORWICH RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
POWELL
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37849-4600
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
865-859-9668
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2018 W CLINCH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37916-2301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-541-8000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/22/2011

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: 163WN0002X , with the licence number:  137339 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LN0000X , with the licence number: 16336 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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