| NPI | 1073220547 |
|---|---|
| Former Name | JENNIFER LYNN COOK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R185480) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: DE L8-0010385) |
| Enumeration Date | 2022-11-03 |
| Last Update Date | 2024-05-16 |