Individual
JENNIFER ANNE COOPER-LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-2115
(417) 820-5344
Mailing address
PO BOX 504274, SAINT LOUIS, MO 63150-4274
(417) 829-4620
(417) 829-4316
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
068394
GA
207P00000X
Emergency Medicine Physician
Primary
2015015950
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720228950
—
MO
Enumeration date
02/27/2009
Last updated
12/02/2015
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