Cook, Kenneth Robert
Cook, Kenneth Robert is an individual health care provider with primary practice located at 410 Council Cir , Tupelo MS 38801-4938. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Cook, Kenneth Robert can be contacted via phone (662) 377-5400.Contact Information
Primary practice address
410 Council Cir
Tupelo MS 38801-4938
Phone: (662) 377-5400
Fax: (662) 377-5415
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | R867598 | Mississippi |
Profile Details
| NPI number | 1831161397 |
|---|---|
| LBN Legal business name | Cook, Kenneth Robert |
| Credentials | NURSE PRACTITIONER |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 7th, 2006 |
| Last updated | Oct 30th, 2009 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1831161397 | NPPES |
| Mississippi | MEDICAID | 08083594 |
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