Provider Demographics
NPI:1760125934
Name:COOKE, ANGEL A
Entity Type:Individual
Prefix:MRS
First Name:ANGEL
Middle Name:A
Last Name:COOKE
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 1:917 PINE ST APT B
Mailing Address - Street 2:
Mailing Address - City:TUSCUMBIA
Mailing Address - State:AL
Mailing Address - Zip Code:35674-1044
Mailing Address - Country:US
Mailing Address - Phone:256-436-7928
Mailing Address - Fax:
Practice Address - Street 1:917 PINE ST APT B
Practice Address - Street 2:
Practice Address - City:TUSCUMBIA
Practice Address - State:AL
Practice Address - Zip Code:35674-1044
Practice Address - Country:US
Practice Address - Phone:256-856-6009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-15
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide