Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | RN095692 | GA |
NPI | 1235321530 |
---|---|
Provider Name | Mrs. Kim Verleigh Cooley |
First Address | Powder Springs, GA 30127-6810 |
Second Address | Atlanta, GA 30328-5382 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2007 |
Last Update Date | 10/08/2007 |