Individual
DEDRA DAWN COOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
13300 S CLEVELAND AVE STE 56, FORT MYERS, FL 33907-3871
(239) 292-3871
(239) 244-2118
Mailing address
4403 E 19TH ST, LEHIGH ACRES, FL 33972-1400
(765) 432-7195
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP9301536
FL
Other
Enumeration date
05/05/2018
Last updated
10/03/2022
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