MEDICARE: SHARON M COOLEY APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	9382212	FL
2	363L00000X	Nurse Practitioner	NP 08653	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053487819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON M COOLEY APRN

Provider Business Mailing Address
First Line	:	PO BOX 578
Second Line	:
City	:	GREEN COVE SPRINGS
State	:	FL
Zip	:	32043-0578
Country	:	US
Telephone Number	:	904-213-3259
Fax Number	:

Provider Business Practice Location Address
First Line	:	1845 TOWN CENTER BLVD STE 400
Second Line	:
City	:	FLEMING ISLAND
State	:	FL
Zip	:	32003-3356
Country	:	US
Telephone Number	:	904-529-2800
Fax Number	:	904-529-2802

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/24/2006
Last Update Date	:	03/10/2026

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Directions to “ SHARON M COOLEY APRN” Practice Location

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