Provider Demographics
NPI:1174306971
Name:COOLEY, ERIC LEE (BSN, RN)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:LEE
Last Name:COOLEY
Suffix:
Gender:M
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3617 STAR GAZING LN
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-6846
Mailing Address - Country:US
Mailing Address - Phone:614-557-0738
Mailing Address - Fax:
Practice Address - Street 1:3617 STAR GAZING LN
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-6846
Practice Address - Country:US
Practice Address - Phone:614-557-0738
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-15
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001303481163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine