Provider Demographics
NPI:1376514554
Name:COOK, JESSIE NECHOLE
Entity Type:Individual
Prefix:MRS
First Name:JESSIE
Middle Name:NECHOLE
Last Name:COOK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COMDT (CG-1122) U.S. COAST GUARD
Mailing Address - Street 2:2100 2ND ST. SW SUITE 5314
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20593-0001
Mailing Address - Country:US
Mailing Address - Phone:251-441-6404
Mailing Address - Fax:251-440-6415
Practice Address - Street 1:AVIATION TRAINING CENTER MOBILE
Practice Address - Street 2:8501 TANNER WILLIAMS RD
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608
Practice Address - Country:US
Practice Address - Phone:251-441-6404
Practice Address - Fax:251-441-6415
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other