Individual
JADA COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
715-A DIVISION STREET, BILOXI, MS 39530
(228) 374-4991
(228) 374-0856
Mailing address
PO BOX 475, BILOXI, MS 39533-0475
(228) 374-2494
(228) 374-0856
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R859997
MS
363LF0000X
Family Nurse Practitioner
R859997
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00126712
—
MS
Enumeration date
03/01/2006
Last updated
11/01/2011
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