JACKLINE OTIENO COOK NP NPI 1821712654

NPI Information

  • NPI: 1821712654
  • Provider Name: JACKLINE OTIENO COOK, NP
  • Classification: Nurse Practitioner - 363LA2100X
  • Specialization: Acute Care
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1300 W TERRELL AVE STE K230
    FORT WORTH, TX
    ZIP 76104
  • Phone: (817) 250-4906

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NPI Details

Jackline Otieno Cook, NP is an acute care nurse practitioner in Fort Worth, TX with 4 years of experience. Jackline Otieno Cook, NP NPI is 1821712654. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1300 W TERRELL AVE STE K230
FORT WORTH, TX
ZIP 76104-104
Phone: (817) 250-4906

The NPI 1821712654 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/26/2022 and was last updated on 2/11/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LA2100XNurse PractitionerAcute CareATEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1363LA2100XOTHERTEXASTAXONOMY CODE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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