Most Relevant Information
Provider Data
NPI Number: | 1003404732 |
Provider Name: | KAYLA MARIE COOLEY FNP-C |
Entity Type: | Individual |
Taxonomy Code: | 363LF0000X |
Specialty: | Nurse Practitioner |
License Number: | 904346 |
Most Important Dates
Enumeration Date: | 01/07/2021 |
Last Updated: | 03/25/2021 |
Provider Practice Location
1710 W 12TH ST
LAUREL
MS
394402559
Practice Location Phone/Fax
Phone: | 6013692028 |
Fax: |
Provider Mailing Location
PO BOX 138
CLARA
MS
393240138
Provider Mailing Phone/Fax
Phone: | |
Fax: |