Provider Demographics
NPI:1396043089
Name:COOK, MICHELLE JONES (R PH)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:JONES
Last Name:COOK
Suffix:
Gender:F
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1213 MISTY MORNING WAY
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603-7504
Mailing Address - Country:US
Mailing Address - Phone:919-327-4741
Mailing Address - Fax:919-661-2472
Practice Address - Street 1:2680 TIMBER DR
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-2571
Practice Address - Country:US
Practice Address - Phone:919-661-9988
Practice Address - Fax:919-661-2472
Is Sole Proprietor?:No
Enumeration Date:2011-03-04
Last Update Date:2011-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12566183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist