Individual
TAWANNA COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1981 N WOODSTOCK ST, PHILADELPHIA, PA 19121-2118
(215) 235-5040
(215) 235-7947
Mailing address
260 S BROAD ST, PHILADELPHIA, PA 19102-5021
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN535143
PA
Other
Enumeration date
10/16/2012
Last updated
10/16/2012
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