Basic Information
| Provider Information | |||||||||
| NPI: | 1235321530 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COOLEY | ||||||||
| FirstName: | KIM | ||||||||
| MiddleName: | VERLEIGH | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | NNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14 KATRINA DR | ||||||||
| Address2: | |||||||||
| City: | POWDER SPRINGS | ||||||||
| State: | GA | ||||||||
| PostalCode: | 301276810 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7704899477 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5901 PEACHTREE DUNWOODY RD NE | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303285382 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4042529751 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2007 | ||||||||
| LastUpdateDate: | 08/10/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LN0005X | RN095692 | GA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Neonatal, Critical Care |
No ID Information.