Individual
LACY MAE COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
816 MIDDLE ST, PITTSBURGH, PA 15212-4915
(412) 321-4001
Mailing address
953 HASLAGE AVE, PITTSBURGH, PA 15212-3427
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP019976
PA
Other
Enumeration date
03/16/2019
Last updated
01/07/2020
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