Individual ProviderKrystal CookNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address9070 Dixie Hwy Ste 6, Louisville, KY 40258-1007(502) 271-3236(502) 253-4900PECOS EnrollmentBased on the most recent information from CMS, provider Krystal Cook is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1881021590Provider TypeIndividualFull NameCook, KrystalTitleMs.CredentialN.P.GenderFemaleSole ProprietorNoEnumeration Date9/27/2013Last Updated12/27/2018Contact InformationPractice LocationPractice Address9070 Dixie Hwy Ste 6, Louisville, KY 40258-1007Phone(502) 271-3236Fax(502) 271-3356Mailing LocationMailing Address2700 Stanley Gault Pkwy Ste 129, Louisville, KY 40223-5176Phone(502) 253-4900Fax(502) 489-5751Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense3008286Kentucky