Provider Demographics
NPI:1144372988
Name:COOK, LINDA DIANNE (RN)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:DIANNE
Last Name:COOK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7671 NE 301 RD
Mailing Address - Street 2:
Mailing Address - City:LOWRY CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64763-9203
Mailing Address - Country:US
Mailing Address - Phone:417-644-2381
Mailing Address - Fax:
Practice Address - Street 1:1600 N 2ND ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MO
Practice Address - Zip Code:64735-1192
Practice Address - Country:US
Practice Address - Phone:660-890-7341
Practice Address - Fax:660-885-6386
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO095227163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse