Individual
JEANETTE COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
401 SAN MATEO BLVD SE, PMG SAN MATEO, ALBUQUERQUE, NM 87108-2921
(505) 462-7333
(505) 462-2010
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
404
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000Q6676
—
NM
Enumeration date
10/03/2006
Last updated
08/31/2015
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