Individual
ANNA MARYALICE COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
700 HIGH ST, WILLIAMSPORT, PA 17701-3100
(570) 321-3454
(570) 321-3455
Mailing address
1201 GRAMPIAN BLVD, WILLIAMSPORT, PA 17701-1900
(570) 326-8723
(570) 326-8922
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP023296
PA
Other
Enumeration date
03/04/2021
Last updated
05/06/2021
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