Individual
MELISSA LYNN COOPER
Active
Individual
MELISSA LYNN COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
10001330A
IN
363AS0400X
Surgical Physician Assistant
99048717A
IN
Other
Enumeration date
09/23/2011
Last updated
06/24/2016
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