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Individual
MR. PAUL ROBERT COOLEY JR.
Active
Individual
MR. PAUL ROBERT COOLEY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP024504
PA
363LP2300X
Primary Care Nurse Practitioner
SP024504
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103993702
—
PA
01
—
CAQH
15509988
—
Enumeration date
11/23/2021
Last updated
01/08/2024
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