Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | 1-135062 | AL |
Y | 363LG0600X | Nurse Practitioner - Gerontology | 1-135062 | AL |
NPI | 1083150601 |
---|---|
Provider Name | Harold Matthew Cooper |
First Address | Birmingham, AL 35209-5344 |
Second Address | Bessemer, AL 35022-6024 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/01/2017 |
Last Update Date | 07/01/2017 |