Healthcare Provider Details

I. General information

NPI: 1427906619
Provider Name (Legal Business Name): MARY COOL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATIE COOL RN, BSN

II. Dates (important events)

Enumeration Date: 03/21/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1063 BRUSH ARBOR CIR
MCDONOUGH GA
30252-5595
US

IV. Provider business mailing address

1063 BRUSH ARBOR CIR
MCDONOUGH GA
30252-5595
US

V. Phone/Fax

Practice location:
  • Phone: 404-510-5666
  • Fax:
Mailing address:
  • Phone: 404-510-5666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN223492
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: