Provider Demographics
NPI:1386041895
Name:COOK, PHILLIP JEFFERY (NP)
Entity type:Individual
Prefix:
First Name:PHILLIP
Middle Name:JEFFERY
Last Name:COOK
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1477 W COMMERCE CT
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85746-6016
Mailing Address - Country:US
Mailing Address - Phone:520-792-3292
Mailing Address - Fax:520-792-4336
Practice Address - Street 1:620 N CRAYCROFT RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-1448
Practice Address - Country:US
Practice Address - Phone:520-519-8540
Practice Address - Fax:520-747-3259
Is Sole Proprietor?:No
Enumeration Date:2014-11-26
Last Update Date:2025-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP7480363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner