Provider Demographics
NPI:1912139650
Name:COOK, BRIDGER (CFA)
Entity type:Individual
Prefix:
First Name:BRIDGER
Middle Name:
Last Name:COOK
Suffix:
Gender:F
Credentials:CFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10733 KIMBALL ST
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-7616
Mailing Address - Country:US
Mailing Address - Phone:720-297-6854
Mailing Address - Fax:720-389-7500
Practice Address - Street 1:10733 KIMBALL ST
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-7616
Practice Address - Country:US
Practice Address - Phone:720-297-6854
Practice Address - Fax:720-389-7500
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-13
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO115521363AS0400X, 246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO115521OtherCERTIFIED SURGICAL FIRST ASSIST