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Contact Information

KIMBERLY M COOK
2500 N STATE ST
JACKSON, MS39216-4500
 Phone: 601-815-1312
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Military Health Care Provider

171000000X
 

Surgical

363AS0400X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for KIMBERLY M COOK · (Female)

NPI Number 1003370230
Status Active
Credentials
Entity Individual
Enumeration date 01/22/2019
Last updated 09/12/2024 - More than a year ago
Sole proprietor 1 Yes
Identifiers
  • CO License # PA.0006218
  • MS License # PA00757
Hospital affiliation(s)
  • MEMORIAL HOSPITAL CENTRAL - (Acute Care)
    1400 E BOULDER ST
    COLORADO SPRINGS, CO 80909
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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