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General NPI Number Information
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NPI Number | 1578490546
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Entity Type | Organization
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Legal Business Name | COONEY FAMILY CARE PLLC
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Dates
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Enumeration Date | 05/05/2026
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Last Update Date | 05/05/2026
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Provider Practice Location Address
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Address Line | 5503 E US HIGHWAY 62
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City | BEAVER DAM
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State | KY
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Zip | 42320-8945
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Country | US
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Telephone | 270-532-3170
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Fax |
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Provider Business Mailing Address
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Address Line | 5503 E US HIGHWAY 62
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City | BEAVER DAM
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State | KY
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Zip | 42320-8945
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Country | US
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Telephone | 270-532-3170
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | TINA GAY CASE COONEY
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Credential | APRN
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Telephone | 270-363-4458
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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