Provider Demographics
NPI:1780651349
Name:COOK, JO-ANN LANOUETTE (MSN,APRN,BC,FNP)
Entity type:Individual
Prefix:MS
First Name:JO-ANN
Middle Name:LANOUETTE
Last Name:COOK
Suffix:
Gender:F
Credentials:MSN,APRN,BC,FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 MORRIS DR
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:LA
Mailing Address - Zip Code:71055-3053
Mailing Address - Country:US
Mailing Address - Phone:318-377-8260
Mailing Address - Fax:318-377-9053
Practice Address - Street 1:208 MORRIS DR
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:LA
Practice Address - Zip Code:71055-3053
Practice Address - Country:US
Practice Address - Phone:318-377-8260
Practice Address - Fax:318-377-9053
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2013-02-12
Deactivation Date:2013-02-07
Deactivation Code:
Reactivation Date:2013-02-12
Provider Licenses
StateLicense IDTaxonomies
LA516891212363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1685461Medicaid
LA5X364Medicare ID - Type Unspecified
LA1685461Medicaid