Individual
SHANTANA COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
208 GARDEN LILY LN, SUMMERVILLE, SC 29485-9230
(843) 801-8306
Mailing address
208 GARDEN LILY LN, SUMMERVILLE, SC 29485-9230
(843) 801-8306
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
245757
SC
Other
Enumeration date
09/23/2025
Last updated
09/23/2025
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