Provider Demographics
NPI:1568586899
Name:COOLEY, AMBER ROSE (CNP,)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:ROSE
Last Name:COOLEY
Suffix:
Gender:F
Credentials:CNP,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 BUTTRICK RD STE 102
Mailing Address - Street 2:
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-3417
Mailing Address - Country:US
Mailing Address - Phone:603-537-1300
Mailing Address - Fax:
Practice Address - Street 1:14 TSIENNETO RD
Practice Address - Street 2:
Practice Address - City:DERRY
Practice Address - State:NH
Practice Address - Zip Code:03038-1647
Practice Address - Country:US
Practice Address - Phone:603-537-1300
Practice Address - Fax:603-845-5135
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN246252363LP0808X
MA246252363LP0808X
NH050131-23363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health