Provider Demographics
NPI:1346214335
Name:FOOS, COLLEEN COOKE (MD)
Entity Type:Individual
Prefix:DR
First Name:COLLEEN
Middle Name:COOKE
Last Name:FOOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 70TH AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-4632
Mailing Address - Country:US
Mailing Address - Phone:970-810-6353
Mailing Address - Fax:970-810-2264
Practice Address - Street 1:2001 70TH AVE STE 300
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-4632
Practice Address - Country:US
Practice Address - Phone:970-810-6353
Practice Address - Fax:970-810-2264
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD065010L207V00000X
CODR.0061760207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
012292PVFMedicare ID - Type Unspecified
G75266Medicare UPIN