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NPI Code Detail

MEDICARE: MS. JAMIE COOK FNP-BC

MEDICARE: MS. JAMIE COOK FNP-BC
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
1363LF0000XFamily Nurse Practitioner652857TX

General Provider Information

NPI Number : 1720538093
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JAMIE COOK FNP-BC
Provider Business Mailing Address
First Line : 3328 N UNIVERSITY DR
Second Line :
City : NACOGDOCHES
State : TX
Zip : 75965-2681
Country : US
Telephone Number : 936-568-3141
Fax Number : 936-560-3872
Provider Business Practice Location Address
First Line : 3328 N UNIVERSITY DR
Second Line :
City : NACOGDOCHES
State : TX
Zip : 75965-2681
Country : US
Telephone Number : 936-568-3141
Fax Number : 936-560-3872
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2016
Last Update Date : 02/03/2025

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