Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 1-135655 | AL |
N | 363LA2100X | Nurse Practitioner - Acute Care | 1-135655 | AL |
NPI | 1033500517 |
---|---|
Provider Name | Abbey Cooper |
First Address | Muscle Shoals, AL 35662-2587 |
Second Address | Sheffield, AL 35660-4020 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2015 |
Last Update Date | 05/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1326373861 | GROUP NPI (01) | AL |