Individual
MS. MEKENZIE COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
361 E 1200 S STE 201, OREM, UT 84058-6904
(801) 224-3014
(801) 224-4914
Mailing address
361 E 1200 S STE 201, OREM, UT 84058-6904
(801) 224-3014
(801) 224-4914
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5646800-4405
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
260022408
RAILROAD MEDICARE
UT
05
—
876000308007
—
UT
Enumeration date
09/30/2010
Last updated
12/02/2022
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