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Jamie Colleen Cooley

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

9200 W Wisconsin Ave, Milwaukee, WI 53226

PECOS Enrollment

This provider is enrolled in PECOS as JAMIE COOLEY.

Based on the most recent information from CMS, provider Jamie Colleen Cooley is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1114448560
Provider Type
Individual
Full Name
Cooley, Jamie Colleen
Gender
Female

Sole Proprietor
No
Enumeration Date
7/6/2017
Last Updated
4/16/2019

Contact Information

Practice Location

9200 W Wisconsin Ave, Milwaukee, WI 53226

(414) 805-3100

(414) 259-1145

Mailing Location

9200 W Wisconsin Ave, Milwaukee, WI 53226-3522

(414) 805-3100

(414) 259-1145

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 4115 Wisconsin

Provider Identifiers

ID	Description	Issuer
ID 1114448560	Description Medicaid	Issuer Unlisted Wisconsin

Jamie Colleen Cooley

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Collings, Breanne Marie

Basse, Erika J

Loftis, Shannon

Safranek, Angela M

Beine, Erica Lynn

Buczkowski, Lauren Holly

Strege, Brittni Marie

Kazik, Jacqueline

Lemke, Pooja Singh

Novak, Nicole