Individual
DANA LEE COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
413 W GRAND AVE, CAMPBELL, MO 63933-1523
(573) 246-2582
(573) 246-3246
Mailing address
413 W GRAND AVE, CAMPBELL, MO 63933-1523
(573) 246-2582
(573) 246-3246
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
093670
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010626
GROUP PROVIDER TRANSACTION ACCESS NUMBER
MO
05
—
428416705
—
MO
01
—
838710626
PROVIDER TRANSACTION ACCESS NUMBER
MO
Enumeration date
03/10/2008
Last updated
12/05/2014
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