Provider Demographics
NPI:1154517027
Name:JONES, JODI COOK (NP)
Entity type:Individual
Prefix:MRS
First Name:JODI
Middle Name:COOK
Last Name:JONES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:JODI
Other - Middle Name:
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:359 W CARMEN ST
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-3527
Mailing Address - Country:US
Mailing Address - Phone:480-730-2840
Mailing Address - Fax:
Practice Address - Street 1:2163 E BASELINE RD
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-1541
Practice Address - Country:US
Practice Address - Phone:480-820-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-24
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP2771363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner