Provider Demographics
NPI:1780965897
Name:COONEY, DEBORAH A (CNP)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:A
Last Name:COONEY
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6559 WILSON MILLS RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:MAYFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44143-6402
Mailing Address - Country:US
Mailing Address - Phone:440-449-1540
Mailing Address - Fax:440-460-2833
Practice Address - Street 1:2050 S COTTONWOOD DR
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-3014
Practice Address - Country:US
Practice Address - Phone:480-704-4540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-01
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH10796-NP363LW0102X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health