Provider Demographics
NPI:1740632504
Name:COOL, KARLA JEAN
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:JEAN
Last Name:COOL
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 1:1031 LAWRENCE CIR
Mailing Address - Street 2:
Mailing Address - City:SARTELL
Mailing Address - State:MN
Mailing Address - Zip Code:56377-2081
Mailing Address - Country:US
Mailing Address - Phone:329-291-3882
Mailing Address - Fax:
Practice Address - Street 1:1031 LAWRENCE CIR
Practice Address - Street 2:
Practice Address - City:SARTELL
Practice Address - State:MN
Practice Address - Zip Code:56377-2081
Practice Address - Country:US
Practice Address - Phone:329-291-3882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-05
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 152706-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse