Provider Demographics
NPI:1407688781
Name:COOKE, MARY ALLISON (RN, BSN, MBA)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:ALLISON
Last Name:COOKE
Suffix:
Gender:F
Credentials:RN, BSN, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3016 PICKETT RD APT 506
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-6081
Mailing Address - Country:US
Mailing Address - Phone:919-525-5705
Mailing Address - Fax:
Practice Address - Street 1:3016 PICKETT RD APT 506
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-6081
Practice Address - Country:US
Practice Address - Phone:919-525-5705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-15
Last Update Date:2024-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC294866163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse