Healthcare Provider Details

I. General information

NPI: 1780651349
Provider Name (Legal Business Name): JO-ANN LANOUETTE COOK MSN,APRN,BC,FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2006
Last Update Date: 02/12/2013
Certification Date:
Deactivation Date: 02/07/2013
Reactivation Date: 02/12/2013

III. Provider practice location address

208 MORRIS DR
MINDEN LA
71055-3053
US

IV. Provider business mailing address

208 MORRIS DR
MINDEN LA
71055-3053
US

V. Phone/Fax

Practice location:
  • Phone: 318-377-8260
  • Fax: 318-377-9053
Mailing address:
  • Phone: 318-377-8260
  • Fax: 318-377-9053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number516891212
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: