Provider Demographics
NPI:1659078665
Name:COOKS, JESSICA R (APRN, FNP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:R
Last Name:COOKS
Suffix:
Gender:F
Credentials:APRN, FNP
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:RANA
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2780 HOMESTEAD RD STE 105
Mailing Address - Street 2:
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89048-5464
Mailing Address - Country:US
Mailing Address - Phone:775-727-7959
Mailing Address - Fax:
Practice Address - Street 1:2780 HOMESTEAD RD STE 105
Practice Address - Street 2:
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048-5464
Practice Address - Country:US
Practice Address - Phone:775-727-7959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-09
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV863553363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner