Individual
MS. SANDRA M COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
5479 POTTSVILLE PIKE, LEESPORT, PA 19533-8633
(610) 916-1050
Mailing address
2442 BRODHEAD RD, BETHLEHEM, PA 18020-8910
(610) 758-8011
(610) 758-8013
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
SP010119
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102509963
—
PA
Enumeration date
09/14/2009
Last updated
05/02/2016
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