Healthcare Provider Details

I. General information

NPI: 1265378251
Provider Name (Legal Business Name): KIERRA COOKS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2026
Last Update Date: 09/05/2026
Certification Date: 09/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46480 MONTE DR
HAMMOND LA
70401-4861
US

IV. Provider business mailing address

PO BOX 116
NATALBANY LA
70451-0116
US

V. Phone/Fax

Practice location:
  • Phone: 985-351-9054
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number215316
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: