Individual
CARLY HAMPTON COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
1034 S BRENTWOOD BLVD, SAINT LOUIS, MO 63117-1223
(314) 617-3001
Mailing address
1034 S BRENTWOOD BLVD, SAINT LOUIS, MO 63117-1223
(314) 617-3001
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2014024114
MO
363LA2100X
Acute Care Nurse Practitioner
Primary
2025002104
MO
Other
Enumeration date
12/18/2024
Last updated
01/29/2025
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