Individual
CODY EDWARD COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
740 HIGH ST STE 1003, WILLIAMSPORT, PA 17701-3102
(570) 321-3160
(570) 321-3161
Mailing address
1201 GRAMPIAN BLVD, WILLIAMSPORT, PA 17701-1900
(570) 326-8723
(570) 326-8922
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP022138
PA
Other
Enumeration date
07/29/2020
Last updated
07/31/2020
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