Provider Demographics
NPI:1538212964
Name:COOK, NANCY JANE (RN)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:JANE
Last Name:COOK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1046 S BRAHMA LN
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-3320
Mailing Address - Country:US
Mailing Address - Phone:928-783-2511
Mailing Address - Fax:
Practice Address - Street 1:1046 S BRAHMA LN
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-3320
Practice Address - Country:US
Practice Address - Phone:928-783-2511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN051092163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool