Individual
MRS. ANNETTE COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
501 MORRIS ST, CHARLESTON, WV 25301
(304) 388-6261
(304) 388-3604
Mailing address
PO BOX 397, CHAPMANVILLE, WV 25508
(304) 855-7017
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
32673
WV
367500000X
Certified Registered Nurse Anesthetist
Primary
39094
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0064977000
—
WV
01
—
430008741
RR MEDICARE
WV
Enumeration date
11/09/2006
Last updated
03/13/2015
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