Provider Demographics
NPI:1497728257
Name:COOLEY, BETH ANN (PA C)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:ANN
Last Name:COOLEY
Suffix:
Gender:F
Credentials:PA C
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:ANN
Other - Last Name:STRAWBRIDGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1086 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15905-4305
Mailing Address - Country:US
Mailing Address - Phone:814-534-1650
Mailing Address - Fax:814-539-3906
Practice Address - Street 1:1086 FRANKLIN ST
Practice Address - Street 2:GROUND FL, GOOD SAMARITAN BLDG
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15905-4305
Practice Address - Country:US
Practice Address - Phone:814-410-8300
Practice Address - Fax:814-410-8331
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA000866L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
S67073Medicare UPIN
PA096846Medicare ID - Type Unspecified