Provider Demographics
NPI:1083840797
Name:COOK, JAIME MARIE (AA)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:MARIE
Last Name:COOK
Suffix:
Gender:F
Credentials:AA
Other - Prefix:
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Mailing Address - Street 1:6701 ROCKSIDE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OH
Mailing Address - Zip Code:44131-2316
Mailing Address - Country:US
Mailing Address - Phone:216-674-5230
Mailing Address - Fax:216-674-5231
Practice Address - Street 1:6701 ROCKSIDE RD STE 200
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:OH
Practice Address - Zip Code:44131-2316
Practice Address - Country:US
Practice Address - Phone:216-674-5230
Practice Address - Fax:216-674-5231
Is Sole Proprietor?:No
Enumeration Date:2009-06-09
Last Update Date:2020-04-03
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2996085Medicaid