Individual
LANA COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
2149 STATELINE RD W, SOUTHAVEN, MS 38671-1222
(662) 342-1112
(662) 393-1478
Mailing address
2149 STATELINE RD W, SOUTHAVEN, MS 38671-1222
(662) 342-1112
(662) 393-1478
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
905696
MS
Other
Enumeration date
02/03/2023
Last updated
06/06/2023
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