Individual
ESTACIA D COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
4444 E 41ST ST, TULSA, OK 74135-2527
(918) 619-4400
(918) 619-4216
Mailing address
PO BOX 268838, OKLAHOMA CITY, OK 73126-8838
(918) 619-4400
(918) 619-4216
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
80155
OK
364S00000X
Clinical Nurse Specialist
80155
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200245210A
—
OK
Enumeration date
09/18/2008
Last updated
01/13/2021
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