Provider Demographics
NPI:1427434562
Name:COOPER, ANNE DONALDSON
Entity type:Individual
Prefix:MISS
First Name:ANNE
Middle Name:DONALDSON
Last Name:COOPER
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:ANNE
Other - Middle Name:DONALDSON
Other - Last Name:COOPER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN, BSN, MPH
Mailing Address - Street 1:510 WOODLAND TER
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4512
Mailing Address - Country:US
Mailing Address - Phone:215-668-6119
Mailing Address - Fax:
Practice Address - Street 1:510 WOODLAND TER
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4512
Practice Address - Country:US
Practice Address - Phone:215-668-6119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-30
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY672908163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse