Individual
MRS. ANNETTE COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
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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