Individual
DONNA MARIE COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
500 ARCADE AVE STE 400, ELKHART, IN 46514-2487
(574) 522-2284
(574) 522-3952
Mailing address
710 N NILES AVE, SOUTH BEND, IN 46617-1924
(574) 647-1610
(574) 237-6069
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71002700A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200977080
—
IN
Enumeration date
05/11/2009
Last updated
11/21/2017
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