Individual
MS. SHONNDA RENEE COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2244 BLASS DR, FLORENCE, SC 29505-6479
(646) 472-4558
Mailing address
13313 142ND ST FL 2, JAMAICA, NY 11436-2140
(646) 472-4558
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
217265-1
NY
Other
Enumeration date
05/03/2018
Last updated
05/03/2018
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