=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912828443
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | WYNETTA LATOYA DENISE COOKS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/22/2026
-----------------------------------------------------
Last Update Date | 07/22/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | P.O. BOX 6
-----------------------------------------------------
City | SARALAND
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 36571
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 678-570-8541
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | P.O. BOX 6
-----------------------------------------------------
City | SARALAND
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 36571
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 678-570-8541
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WA0400X
-----------------------------------------------------
Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
-----------------------------------------------------
License Number | 1-136636
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | 1-136636
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------