Individual
JACQUELINE DENISE COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
1225 E GARRISON BLVD, GASTONIA, NC 28054-5115
(704) 865-7416
Mailing address
PO BOX 744786, ATLANTA, GA 30374-4786
(704) 865-7416
Taxonomy
Speciality
Code
Description
License number
State
163WM0102X
Maternal Newborn Registered Nurse
268283
NC
367A00000X
Advanced Practice Midwife
Primary
850
NC
Other
Enumeration date
08/27/2019
Last updated
10/12/2022
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