Provider Demographics
NPI:1235321530
Name:COOLEY, KIM VERLEIGH (NNP)
Entity Type:Individual
Prefix:MRS
First Name:KIM
Middle Name:VERLEIGH
Last Name:COOLEY
Suffix:
Gender:F
Credentials:NNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 KATRINA DR
Mailing Address - Street 2:
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-6810
Mailing Address - Country:US
Mailing Address - Phone:770-489-9477
Mailing Address - Fax:
Practice Address - Street 1:5901 PEACHTREE DUNWOODY RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-5382
Practice Address - Country:US
Practice Address - Phone:404-252-9751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-10
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN095692363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care