Individual
MICHELE COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPA-C
Contact information
Practice address
34 PROFFESSIONAL PARK RD, STORRS MANSFIELD, CT 06268-1659
(860) 487-0002
Mailing address
34 PROFFESSIONAL PARK RD, STORRS, CT 06268-1659
(860) 487-0002
(860) 429-1663
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
003581
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6021501
BLUECROSS BLUESHIELD
TN
01
—
9213744
AETNA
TN
01
—
P01455819
RR MEDICARE
TN
05
—
Q006875
—
TN
Enumeration date
01/06/2010
Last updated
07/21/2022
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