Provider Demographics
NPI:1891403226
Name:COOK, MICHELLE JEAN
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:JEAN
Last Name:COOK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:JEAN
Other - Last Name:HARSHBARGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:64 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-3701
Mailing Address - Country:US
Mailing Address - Phone:603-357-4400
Mailing Address - Fax:603-357-9868
Practice Address - Street 1:64 MAIN ST
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-3701
Practice Address - Country:US
Practice Address - Phone:603-357-4400
Practice Address - Fax:603-357-9648
Is Sole Proprietor?:No
Enumeration Date:2022-11-15
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist