Provider Demographics
NPI:1962868414
Name:COOKE, CATHERINE (APRN)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:COOKE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:
Other - Last Name:FOX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:2316 E MEYER BLVD
Mailing Address - Street 2:NICU
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64132-1136
Mailing Address - Country:US
Mailing Address - Phone:816-276-3290
Mailing Address - Fax:816-276-3292
Practice Address - Street 1:2316 E MEYER BLVD
Practice Address - Street 2:MEDICAL STAFF OFFICE
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64132-1136
Practice Address - Country:US
Practice Address - Phone:816-276-3290
Practice Address - Fax:816-276-3292
Is Sole Proprietor?:No
Enumeration Date:2016-01-13
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO144598163W00000X
MO2014025539363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
No163W00000XNursing Service ProvidersRegistered Nurse