Provider Demographics
NPI:1861959033
Name:COOK, LAUREN WALL (WHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:WALL
Last Name:COOK
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 KOGER CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-4778
Mailing Address - Country:US
Mailing Address - Phone:804-897-2100
Mailing Address - Fax:804-897-9074
Practice Address - Street 1:1212 KOGER CENTER BLVD
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-4778
Practice Address - Country:US
Practice Address - Phone:804-897-2100
Practice Address - Fax:804-897-9074
Is Sole Proprietor?:No
Enumeration Date:2019-02-25
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001226022163W00000X
VA0024177429363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No163W00000XNursing Service ProvidersRegistered Nurse