Individual
MINDY COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
645 E MISSOURI AVE STE 300, PHOENIX, AZ 85012-1351
(602) 262-8900
Mailing address
645 E MISSOURI AVE STE 300, PHOENIX, AZ 85012-1351
(602) 262-8900
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
085007
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
218585
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
430039496
RAILROAD MEDICARE
MO
05
—
913594438
—
MO
Enumeration date
05/05/2006
Last updated
11/02/2018
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