Provider Demographics
NPI:1699132803
Name:COOK, COURTNEY D
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:D
Last Name:COOK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3029 S SHERWOOD FOREST BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-5230
Mailing Address - Country:US
Mailing Address - Phone:225-275-3039
Mailing Address - Fax:
Practice Address - Street 1:3029 S SHERWOOD FOREST BLVD STE 100
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-5230
Practice Address - Country:US
Practice Address - Phone:225-275-3039
Practice Address - Fax:225-275-9068
Is Sole Proprietor?:No
Enumeration Date:2016-01-19
Last Update Date:2021-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator