Individual
MRS. JANE M COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
1189 TIBWIN ROAD, MCCLELLANVILLE, SC 29458-9405
(843) 887-3274
(843) 887-3929
Mailing address
P.O. BOX 608, MCCLELLANVILLE, SC 29458-0608
(843) 887-3274
(843) 887-3929
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F3048
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0364690
—
MA
Enumeration date
10/31/2005
Last updated
08/29/2017
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