Individual
BROOKE ANN COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
805 HILL BLVD UNIT 104, GRANBURY, TX 76048-1482
(817) 573-5688
Mailing address
401 MAIN ST, BENTON, KY 42025
(270) 906-0369
(270) 906-0371
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
AP139698
TX
363LF0000X
Family Nurse Practitioner
Primary
3014631
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP139698
TEXAS BOARD OF NURSING
TX
Enumeration date
11/09/2018
Last updated
06/02/2022
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