Individual
JACOB GREGORY COOLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP, CRNA
Contact information
Practice address
1 BOSTON MEDICAL CTR PL, BOSTON, MA 02118-2908
(617) 638-6950
(617) 638-6966
Mailing address
3066 N STATION ST, VERONA, WI 53593-8722
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
10264
WI
367500000X
Certified Registered Nurse Anesthetist
RN697361
PA
Other
Enumeration date
06/12/2017
Last updated
09/02/2021
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