Doctor Name: | MRS. JESSICA HOPE COOK |
NPI Number: | 1063426534 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | 004032 |
Business Practice Address: | 1050 Thomas Ave Watkinsville, GA - 306776071 |
Business Phone Number: | 4065701936 |
Business Fax Number: | |
Mailing Address: | 1050 Thomas Ave, WATKINSVILLE |
State: | GA |
Postal Code: | 306776071 |
Phone Number: | 4065701936 |
Fax Number: | |
NPI Enumeration Date: | 07/28/2006 |
NPI Last Update Date: | 05/01/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 004032 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |