Provider Demographics
NPI:1902806524
Name:COOK, KATHRYN TAYLOR (NP)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:TAYLOR
Last Name:COOK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:MARY
Other - Middle Name:A
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 415000-MSC8135
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37241-8135
Mailing Address - Country:US
Mailing Address - Phone:865-670-6199
Mailing Address - Fax:865-670-6198
Practice Address - Street 1:1924 ALCOA HWY # U56
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920
Practice Address - Country:US
Practice Address - Phone:865-305-9081
Practice Address - Fax:865-305-8769
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8227363LF0000X, 363LA2100X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ022270Medicaid
TN3348794Medicaid
TN103I509303Medicare PIN
TNP00102347Medicare ID - Type UnspecifiedRAILROAD
TN4067295OtherBCBS
P89197Medicare UPIN
TN100043236OtherCARITEN PHP
TN3348794Medicare ID - Type Unspecified
TNTN0103OtherJOHN DEERE