Provider Demographics
NPI:1194168682
Name:BARTHOLOMEW, JAMI COOK (FNP)
Entity type:Individual
Prefix:
First Name:JAMI
Middle Name:COOK
Last Name:BARTHOLOMEW
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2949 CONTIWOOD CV
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:TN
Mailing Address - Zip Code:38002-9219
Mailing Address - Country:US
Mailing Address - Phone:662-515-7222
Mailing Address - Fax:
Practice Address - Street 1:4250 BETHEL RD
Practice Address - Street 2:
Practice Address - City:OLIVE BRANCH
Practice Address - State:MS
Practice Address - Zip Code:38654-8737
Practice Address - Country:US
Practice Address - Phone:662-932-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-15
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN17560363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner