Healthcare Provider Details

I. General information

NPI: 1346162633
Provider Name (Legal Business Name): NANETTE K COOLEY RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 E EUCLID AVE
INDIANOLA IA
50125-1730
US

IV. Provider business mailing address

15976 200TH AVE
MILO IA
50166-6691
US

V. Phone/Fax

Practice location:
  • Phone: 515-962-9399
  • Fax: 515-962-2202
Mailing address:
  • Phone: 515-962-9399
  • Fax: 515-962-2202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number16639
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: