Individual
MRS. STACY E COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
411 FALLS BLVD S, WYNNE, AR 72396
(870) 238-8511
Mailing address
411 FALLS BLVD S, WYNNE, AR 72396-3501
(870) 238-8511
(870) 238-2135
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PD10812
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PD10812
PHARMACY LICENSE NUMBER
AR
Enumeration date
11/05/2008
Last updated
06/23/2022
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