Individual
JACOB COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP, AGNP-C
Contact information
Practice address
2720 8TH ST SW, ALTOONA, IA 50009-1050
(515) 967-0133
Mailing address
201 NE 23RD CT, GRIMES, IA 50111-1225
(515) 360-5451
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
161373
IA
363LF0000X
Family Nurse Practitioner
Primary
1083425615
IA
363LP2300X
Primary Care Nurse Practitioner
1083425615
IA
Other
Enumeration date
01/14/2025
Last updated
03/04/2025
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