Individual
DESISLAVA Y COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1143 NW 89TH DR, GAINESVILLE, FL 32606-7116
(352) 214-1004
Mailing address
1143 NW 89TH DR, GAINESVILLE, FL 32606-7116
(352) 214-1004
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
11001875
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN11001875
FL
Other
Enumeration date
08/28/2019
Last updated
10/18/2024
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