Provider Demographics
NPI:1851434666
Name:COOK, JESSICA RUTH ANNE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:RUTH ANNE
Last Name:COOK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:RUTH ANNE
Other - Last Name:KILGORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:255 WMA RD
Mailing Address - Street 2:
Mailing Address - City:ROCKWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37854-3521
Mailing Address - Country:US
Mailing Address - Phone:865-567-2446
Mailing Address - Fax:
Practice Address - Street 1:103 N. GATEWAY AVE
Practice Address - Street 2:
Practice Address - City:ROCKWOOD
Practice Address - State:TN
Practice Address - Zip Code:37854
Practice Address - Country:US
Practice Address - Phone:865-354-0234
Practice Address - Fax:865-354-8381
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN24538183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist