Individual
KEVIN MAYNARD COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
555 LINN ST, ALLEGAN, MI 49010-1524
(269) 686-5800
Mailing address
2961 122ND AVE, ALLEGAN, MI 49010-8508
(231) 425-6360
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704267613
MI
Other
Enumeration date
09/11/2019
Last updated
09/11/2019
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