Individual
PANSY J COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
241 SINGLETON RIDGE ROAD, SUITE B, MAIN STREET PHYSICIANS, CONWAY, SC 29526
(800) 491-0909
(843) 347-7232
Mailing address
111 DOCTOR CIR, COLUMBIA, SC 29203-6502
(800) 491-0909
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
APN2336
SC
363LF0000X
Family Nurse Practitioner
Primary
2336
SC
363LF0000X
Family Nurse Practitioner
APN2336
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP0452
—
SC
01
—
P00155306
MEDICARE RR
SC
Enumeration date
08/30/2006
Last updated
11/01/2022
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