Provider Demographics
NPI:1487326724
Name:COOK, DELANIE KATHLEEN (CRNP)
Entity type:Individual
Prefix:
First Name:DELANIE
Middle Name:KATHLEEN
Last Name:COOK
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1575 HIGHLANDS DR STE 205
Mailing Address - Street 2:
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-7507
Mailing Address - Country:US
Mailing Address - Phone:717-625-5850
Mailing Address - Fax:717-625-0137
Practice Address - Street 1:1575 HIGHLANDS DRIVE
Practice Address - Street 2:BUILDING A, SUITE 205
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-7507
Practice Address - Country:US
Practice Address - Phone:717-625-5850
Practice Address - Fax:717-625-0137
Is Sole Proprietor?:No
Enumeration Date:2021-10-05
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP024561363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily