Individual
MS. MARY-ELLEN COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
200 DEXTER AVE, SUITE K, WATERTOWN, MA 02472-4238
(617) 600-3195
(617) 924-1207
Mailing address
200 DEXTER AVE, SUITE K, WATERTOWN, MA 02472-4238
(617) 600-3195
(617) 924-1207
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN216769
MA
Other
Enumeration date
08/16/2010
Last updated
08/16/2010
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