Individual
MR. GRANT WAYNE COOPER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MSCN FNP
Contact information
Practice address
6336 W HONEYSUCKLE DR, GLENDALE, AZ 85310-1824
(623) 204-4914
(623) 322-1809
Mailing address
6336 W HONEYSUCKLE DR, GLENDALE, AZ 85310-1824
(623) 204-4914
(623) 322-1809
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP0851
AZ
Other
Enumeration date
10/13/2005
Last updated
07/08/2007
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