Provider Demographics
NPI:1992700082
Name:COONEY, DEBRA A (ARNP)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:A
Last Name:COONEY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:865 LINCOLN RD
Mailing Address - Street 2:STE L10
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-4159
Mailing Address - Country:US
Mailing Address - Phone:563-355-9191
Mailing Address - Fax:563-355-3419
Practice Address - Street 1:865 LINCOLN RD
Practice Address - Street 2:STE 100
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-4159
Practice Address - Country:US
Practice Address - Phone:563-355-1000
Practice Address - Fax:563-344-2975
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA-049566363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA4177253Medicaid
064372OtherHEALTH ALLIANCE
20251OtherIOWA HEALTH SOLUTIONS
29596OtherWELLMARK BC/BS
IA0115OtherJOHN DEERE HEALTH PLAN
4796890005OtherDMERC
IA4177253Medicaid
IAI3086Medicare PIN