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Individual
SHELBI DAWN COOPER
Active
Individual
SHELBI DAWN COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
698233
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200436801
—
TX
01
—
752771569005
TRICARE
TX
01
—
811N02
BCBS BILLING NUMBER
TX
01
—
895N69
BCBS
TX
01
—
TIN PLUS 020
TRICARE
TX
Enumeration date
07/24/2007
Last updated
07/16/2015
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