Individual
MS. PAMELA D COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
480 PENBROOKE DRIVE, SUITE 6, PENFIELD, NY 14526, 309 LATONA RD., ROCHESTER, NY 14626-2117
(585) 498-6326
Mailing address
309 LATONA RD, ROCHESTER, NY 14626-2711
(585) 498-6326
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
612757-1
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
403699
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02688186
—
NY
Enumeration date
09/07/2007
Last updated
06/24/2024
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