Individual
ASHLEY COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
499 GLOSTER CREEK VLG STE A-3, TUPELO, MS 38801-4600
(662) 640-4595
Mailing address
1104 BIENVILLE ST, TUPELO, MS 38801-2404
(662) 213-8950
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
902192
MS
Other
Enumeration date
07/21/2017
Last updated
09/14/2017
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