Provider Demographics
NPI:1235972951
Name:COOKE, TAYLOR JEAN (DNP, FNP-C)
Entity type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:JEAN
Last Name:COOKE
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40175 PECAN ALLEE DR # A
Mailing Address - Street 2:
Mailing Address - City:PONCHATOULA
Mailing Address - State:LA
Mailing Address - Zip Code:70454-9218
Mailing Address - Country:US
Mailing Address - Phone:850-264-5723
Mailing Address - Fax:
Practice Address - Street 1:40175 PECAN ALLEE DR # A
Practice Address - Street 2:
Practice Address - City:PONCHATOULA
Practice Address - State:LA
Practice Address - Zip Code:70454-9218
Practice Address - Country:US
Practice Address - Phone:850-264-5723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAF06240298363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily