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NPI Code Detail

MEDICARE: ANGELIQUE M COOK

MEDICARE: ANGELIQUE M COOK
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1942911227
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELIQUE M COOK
Provider Business Mailing Address
First Line : 107 CHICAGO ST
Second Line :
City : BROOKLYN
State : MI
Zip : 49230-9703
Country : US
Telephone Number : 517-592-1974
Fax Number : 517-592-1975
Provider Business Practice Location Address
First Line : 107 CHICAGO ST
Second Line :
City : BROOKLYN
State : MI
Zip : 49230-9703
Country : US
Telephone Number : 517-592-1974
Fax Number : 517-592-1975
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2022
Last Update Date : 07/15/2025

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