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Individual

MISS TAMMY LYVONNE COOPER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APN-C

Contact information

Practice address
12522 GREAT PARK CIR #303, GERMANTOWN, MD 20876
(240) 301-4866
Mailing address
PO BOX 2718, GERMANTOWN, MD 20875-2718
(240) 301-4866
(848) 213-0287

Taxonomy

Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
26NR11441600
NJ
163WP0808X
Psychiatric/Mental Health Registered Nurse
26NR11441600
NJ
363LA2200X
Adult Health Nurse Practitioner
Primary
26NJ00372800
NJ
363LA2200X
Adult Health Nurse Practitioner
NP500005960
DC
363LA2200X
Adult Health Nurse Practitioner
R233355
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0325279
NJ
Enumeration date
04/03/2007
Last updated
12/21/2023
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