Individual
ANDREW COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
900 PEELER ST, KALAMAZOO, MI 49008-2300
(269) 345-8618
(269) 345-1508
Mailing address
2019 FOX HILL DR APT 12, GRAND BLANC, MI 48439-5206
(616) 617-0672
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704308923
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704308923
MI LICENSE
MI
Enumeration date
07/15/2019
Last updated
05/30/2024
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