Provider Demographics
NPI:1649161274
Name:COOKS, WARETTA SAWYER (NP)
Entity type:Individual
Prefix:
First Name:WARETTA
Middle Name:SAWYER
Last Name:COOKS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 E 16TH AVE
Mailing Address - Street 2:
Mailing Address - City:CORDELE
Mailing Address - State:GA
Mailing Address - Zip Code:31015-1512
Mailing Address - Country:US
Mailing Address - Phone:229-271-0300
Mailing Address - Fax:
Practice Address - Street 1:708 E 16TH AVE
Practice Address - Street 2:
Practice Address - City:CORDELE
Practice Address - State:GA
Practice Address - Zip Code:31015-1512
Practice Address - Country:US
Practice Address - Phone:229-271-0300
Practice Address - Fax:229-271-9892
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN241265363LF0000X, 163WH1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH1000XNursing Service ProvidersRegistered NurseHospiceGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily