Healthcare Provider Details

I. General information

NPI: 1942757042
Provider Name (Legal Business Name): JENNIFER MARIE COOKE DNP, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2016
Last Update Date: 06/06/2021
Certification Date: 06/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

490 DUNLOP LN
CLARKSVILLE TN
37040
US

IV. Provider business mailing address

230 DOVER RD STE C
CLARKSVILLE TN
37042-4183
US

V. Phone/Fax

Practice location:
  • Phone: 931-245-7000
  • Fax:
Mailing address:
  • Phone: 931-920-5000
  • Fax: 931-920-5011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number23060
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: