Individual
TONI L. COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, MSN, CDE
Contact information
Practice address
1040 RIVER OAKS DR, STE. 302, JACKSON, MS 39232-9530
(601) 939-9923
(601) 939-9924
Mailing address
1040 RIVER OAKS DR, STE. 302, JACKSON, MS 39232-9530
(601) 939-9923
(601) 939-9924
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
R501069
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R501069
LICENSE NUMBER
MS
Enumeration date
05/19/2010
Last updated
05/19/2010
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