Provider Demographics
NPI:1619306560
Name:COOL, JENNIFER DICE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:DICE
Last Name:COOL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 MARIAS WAY
Mailing Address - Street 2:
Mailing Address - City:SOUTH PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15129-1007
Mailing Address - Country:US
Mailing Address - Phone:407-739-3423
Mailing Address - Fax:
Practice Address - Street 1:3600 FORBES AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3410
Practice Address - Country:US
Practice Address - Phone:833-716-8447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-01
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9264206363LF0000X
PASP017347363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily