Provider Demographics
NPI:1922360437
Name:COOK, JAMILLA S (LVN)
Entity Type:Individual
Prefix:MRS
First Name:JAMILLA
Middle Name:S
Last Name:COOK
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44544 15TH ST E
Mailing Address - Street 2:#8
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93535-6319
Mailing Address - Country:US
Mailing Address - Phone:661-675-5233
Mailing Address - Fax:
Practice Address - Street 1:44544 15TH ST E
Practice Address - Street 2:#8
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93535-6319
Practice Address - Country:US
Practice Address - Phone:661-675-5233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-11
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA267362164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse