Individual
MARIA J COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
33155 ANNAPOLIS ST, EMERGENCY MEDICINE DEPARTMENT, WAYNE, MI 48184-2405
(734) 467-4042
(734) 467-5500
Mailing address
38935 ANN ARBOR RD, CREDENTIALING/PAYER CONTRACTING, LIVONIA, MI 48150-3397
(734) 632-0175
(734) 632-0182
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704163416
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1588642177
—
MI
Enumeration date
01/04/2006
Last updated
07/20/2010
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