Individual ProviderMary CookNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address1807 W Dickerson St Ste D, Bozeman, MT 59715-1311(406) 404-7384PECOS EnrollmentBased on the most recent information from CMS, provider Mary Cook is legally eligible to order and refer claims for DME and PMD services only.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1861639619Provider TypeIndividualFull NameCook, MaryTitleMrs.CredentialARNPGenderFemaleSole ProprietorNoEnumeration Date1/15/2009Last Updated7/15/2024Contact InformationPractice LocationPractice Address1807 W Dickerson St Ste D, Bozeman, MT 59715-1311Phone(406) 404-7384FaxUnlisted FaxMailing LocationMailing Address1807 W Dickerson St Ste D, Bozeman, MT 59715-1311Phone(406) 404-7384FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense103234MontanaProvider IdentifiersIDDescriptionIssuerID7128408DescriptionMedicaidIssuerUnlistedWashington