Individual
JANAE M COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1279 PLUM CANYON ST, LAS VEGAS, NV 89142-0825
(510) 379-6383
Mailing address
1279 PLUM CANYON ST, LAS VEGAS, NV 89142-0825
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300025260
—
NV
Enumeration date
02/05/2019
Last updated
02/05/2019
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