Individual
JENNIFER BLAKE COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
44 MEDICAL PARK BLVD STE D, PETERSBURG, VA 23805-9351
(804) 520-6730
Mailing address
218 N CHARLES ST APT 2106, BALTIMORE, MD 21201-4026
(804) 572-3707
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110010449
VA
363A00000X
Physician Assistant
—
—
Other
Enumeration date
09/18/2023
Last updated
06/12/2025
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