Individual
BEVERLY COOPER-EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2051 W GRAND BLVD, DETROIT, MI 48208-1105
(313) 961-3642
Mailing address
2051 W GRAND BLVD, DETROIT, MI 48208-1105
(313) 961-3642
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
470144354
MI
Other
Enumeration date
04/22/2015
Last updated
04/22/2015
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