Individual
RICHARD TODD COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1001 GAUSE BLVD, SLIDELL, LA 70458-2939
(985) 643-2200
Mailing address
2375 GAUSE BLVD E, SLIDELL, LA 70461-4142
(985) 643-2200
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
854822
MS
363LA2100X
Acute Care Nurse Practitioner
Primary
AP07104
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09305086
—
MS
05
—
2319345
—
LA
Enumeration date
12/04/2012
Last updated
03/17/2018
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