Provider Demographics
NPI:1114558194
Name:COOL, ERIKA LYNNE (APRN, CNM, CPM)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:LYNNE
Last Name:COOL
Suffix:
Gender:F
Credentials:APRN, CNM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6131 TERRYDALE ST.
Mailing Address - Street 2:
Mailing Address - City:MERRIAM
Mailing Address - State:KS
Mailing Address - Zip Code:66202
Mailing Address - Country:US
Mailing Address - Phone:913-548-1705
Mailing Address - Fax:
Practice Address - Street 1:4831 ANTIOCH RD
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66203-1310
Practice Address - Country:US
Practice Address - Phone:913-548-1705
Practice Address - Fax:913-667-2760
Is Sole Proprietor?:No
Enumeration Date:2020-01-29
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
176B00000X
KS53-79114-111367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife