Individual
TINA COOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
74 THOMAS JOHNSON DR, FREDERICK, MD 21702-4501
(301) 694-9033
Mailing address
1570 WHEYFIELD DR, FREDERICK, MD 21701-2511
(240) 586-1903
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R243396
MD
Other
Enumeration date
08/22/2024
Last updated
11/11/2024
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