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Individual

MARIE COOPER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
R.N.

Contact information

Practice address
1919 E THOMAS RD, PHOENIX, AZ 85016-7710
(630) 933-0940
Mailing address
1919 E THOMAS RD, PHOENIX, AZ 85016-7710
(630) 933-0940

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN170495
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RN170495
REGISTERED NURSE
AZ
Enumeration date
01/17/2021
Last updated
01/17/2021
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