Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | RN53661 | DC |
NPI | 1033201173 |
---|---|
Provider Name | Ms. Angela Y. Cooper |
First Address | Silver Spring, MD 20904-4892 |
Second Address | Washington, DC 20422-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 08/07/2007 |