Healthcare Provider Details

I. General information

NPI: 1053487819
Provider Name (Legal Business Name): SHARON M COOLEY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/24/2006
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1845 TOWN CENTER BLVD STE 400
FLEMING ISLAND FL
32003-3356
US

IV. Provider business mailing address

PO BOX 578
GREEN COVE SPRINGS FL
32043-0578
US

V. Phone/Fax

Practice location:
  • Phone: 904-529-2800
  • Fax: 904-529-2802
Mailing address:
  • Phone: 904-213-3259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9382212
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP 08653
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: