Provider Demographics
NPI:1902499734
Name:COOK, JASMINE NICOLE (CNA)
Entity Type:Individual
Prefix:MISS
First Name:JASMINE
Middle Name:NICOLE
Last Name:COOK
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 AMANDA CIR
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-8901
Mailing Address - Country:US
Mailing Address - Phone:224-523-3512
Mailing Address - Fax:
Practice Address - Street 1:2005 MEDINAH CIR
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-6513
Practice Address - Country:US
Practice Address - Phone:224-523-3512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-12
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide