Provider Demographics
NPI:1891296711
Name:COOLEY, RIKA NICHOLE
Entity Type:Individual
Prefix:
First Name:RIKA
Middle Name:NICHOLE
Last Name:COOLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 N NORTHSHORE DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-4048
Mailing Address - Country:US
Mailing Address - Phone:865-588-6755
Mailing Address - Fax:
Practice Address - Street 1:7810 OAK RIDGE HWY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37931-2313
Practice Address - Country:US
Practice Address - Phone:865-690-5357
Practice Address - Fax:865-690-5403
Is Sole Proprietor?:No
Enumeration Date:2018-02-26
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN36027183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist