| Doctor Name: | CLINT COOKSEY |
| NPI Number: | 1205217064 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | FNP-C |
| License Number: | AP08337 |
| Business Practice Address: | 187 Ninth St Jena, LA - 713423900 |
| Business Phone Number: | 3189929200 |
| Business Fax Number: | |
| Mailing Address: | 3721 Highway 459, JENA |
| State: | LA |
| Postal Code: | 713426461 |
| Phone Number: | 3183120943 |
| Fax Number: | 3189929245 |
| NPI Enumeration Date: | 06/17/2015 |
| NPI Last Update Date: | 06/17/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | AP08337 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |