Provider Demographics
NPI:1720482441
Name:COOLEY, JESSICA (PA)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:
Last Name:COOLEY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:PO BOX 5204
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-0603
Mailing Address - Country:US
Mailing Address - Phone:623-889-3477
Mailing Address - Fax:623-889-3478
Practice Address - Street 1:5251 W CAMPBELL AVE STE 105
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85031
Practice Address - Country:US
Practice Address - Phone:623-547-5235
Practice Address - Fax:623-533-6271
Is Sole Proprietor?:No
Enumeration Date:2014-10-09
Last Update Date:2021-10-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ5831363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant