Organization
ADVANCED NP SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBRA COOPER APRN, NP-C (PRESIDENT)
(678) 289-6618
Entity
Organization
Contact information
Practice address
242 SUMMERFORD PL, STOCKBRIDGE, GA 30281-2892
(678) 289-6618
(678) 289-4274
Mailing address
242 SUMMERFORD PL, STOCKBRIDGE, GA 30281-2892
(678) 289-6618
(678) 289-4274
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
RN084801NP
GA
163WS0121X
Plastic Surgery Registered Nurse
RN084801
GA
363L00000X
Nurse Practitioner
RN084801NP
GA
363LF0000X
Family Nurse Practitioner
Primary
RN084801NP
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
511I500088
MEDICARE PROVIDER NUMBER
GA
Enumeration date
01/21/2008
Last updated
09/16/2008
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