Individual
MRS. JACQUALINE M TERRILL COOKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM FNP
Contact information
Practice address
320 SE BAKER ST, MCMINNVILLE, OR 97128-6038
(503) 474-3600
(503) 474-3601
Mailing address
320 SE BAKER ST, MCMINNVILLE, OR 97128-6038
(503) 474-3600
(503) 474-3601
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
200040704RN
OR
363LF0000X
Family Nurse Practitioner
Primary
200350072NPFNPPP
OR
367A00000X
Advanced Practice Midwife
200450066NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
233427
—
OR
Enumeration date
04/13/2006
Last updated
08/14/2023
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