Provider Demographics
NPI:1891439956
Name:COOLEY, KATRINA MARY (PA-C)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:MARY
Last Name:COOLEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2744 WAR ADMIRAL
Mailing Address - Street 2:
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78108-2346
Mailing Address - Country:US
Mailing Address - Phone:361-945-5526
Mailing Address - Fax:
Practice Address - Street 1:US COAST GUARD BASE MIAMI BEACH
Practice Address - Street 2:100 MACARTHUR CAUSEWAY
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139
Practice Address - Country:US
Practice Address - Phone:305-535-4542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-25
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical