Provider Demographics
NPI:1871319277
Name:COOK, AUDREY
Entity type:Individual
Prefix:MRS
First Name:AUDREY
Middle Name:
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 1:3700 9TH ST SE APT 516
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-4020
Mailing Address - Country:US
Mailing Address - Phone:202-468-7245
Mailing Address - Fax:
Practice Address - Street 1:3700 9TH ST SE APT 516
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-4020
Practice Address - Country:US
Practice Address - Phone:202-468-7245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-02
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant