Individual
CHASITY IMANI COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
525 E 15TH ST, PANAMA CITY, FL 32405-5400
(850) 522-4485
(850) 257-7938
Mailing address
304 MONTCLAIR DR, DOTHAN, AL 36301-2933
(334) 790-8439
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN11026964
FL
Other
Enumeration date
06/21/2023
Last updated
04/02/2024
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