MEDICARE: MS. JENNIFER ANNE COOKE M.AC., L.AC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	U01353	MD

General Provider Information

NPI Number	:	1528113651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JENNIFER ANNE COOKE M.AC., L.AC.

Provider Business Mailing Address
First Line	:	6500 FALLS RD
Second Line	:	SUITE 100
City	:	BALTIMORE
State	:	MD
Zip	:	21209-2036
Country	:	US
Telephone Number	:	410-241-7715
Fax Number	:

Provider Business Practice Location Address
First Line	:	6500 FALLS RD
Second Line	:	SUITE 100
City	:	BALTIMORE
State	:	MD
Zip	:	21209-2036
Country	:	US
Telephone Number	:	410-241-7715
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/25/2007
Last Update Date	:	06/09/2015

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