1669974036 NPI number — MS. KAREN MARY COOKE FRANQUI FNP-C

Table of content: MS. KAREN MARY COOKE FRANQUI FNP-C (NPI 1669974036)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669974036 NPI number — MS. KAREN MARY COOKE FRANQUI FNP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COOKE FRANQUI
Provider First Name:
KAREN
Provider Middle Name:
MARY
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
FNP-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
COOKE
Provider Other First Name:
KAREN
Provider Other Middle Name:
MARY
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
FNP-C
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1669974036
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/10/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2070
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLEVELAND
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37320-2070
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
423-339-9581
Provider Business Mailing Address Fax Number:
423-472-0454

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11416 GRIGSBY CHAPEL RD STE 104
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:
37934
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-218-2100
Provider Business Practice Location Address Fax Number:
865-218-2101
Provider Enumeration Date:
03/01/2018

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: 363LF0000X , with the licence number:  23866 , 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)





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