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Individual

LACEY A COOPER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
(702) 281-8904
Mailing address
797 WELLES CANNON RD, GRANTSVILLE, UT 84029-5563
(702) 281-8904

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
9043708-4409
UT

Other

Enumeration date
06/27/2020
Last updated
11/12/2021
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