Individual
MARK EMANUEL COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1201 BROAD ROCK BLVD, MCGUIRE VA MEDICAL CENTER, RICHMOND, VA 23249-0001
(804) 675-5000
(804) 675-5585
Mailing address
13916 HOWLETT LINE DR, COLONIAL HEIGHTS, VA 23834-5865
(804) 530-8335
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
0001125551
VA
Other
Enumeration date
07/12/2006
Last updated
07/08/2007
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