Provider Demographics
NPI:1699315879
Name:COOPER, BRANDI MICHELLE (FNP-C)
Entity type:Individual
Prefix:
First Name:BRANDI
Middle Name:MICHELLE
Last Name:COOPER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 948
Mailing Address - Street 2:
Mailing Address - City:STINNETT
Mailing Address - State:TX
Mailing Address - Zip Code:79083-0948
Mailing Address - Country:US
Mailing Address - Phone:806-443-6213
Mailing Address - Fax:
Practice Address - Street 1:100 S MCGEE ST
Practice Address - Street 2:
Practice Address - City:BORGER
Practice Address - State:TX
Practice Address - Zip Code:79007-4041
Practice Address - Country:US
Practice Address - Phone:806-274-5131
Practice Address - Fax:806-274-5132
Is Sole Proprietor?:No
Enumeration Date:2020-01-15
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP144511363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner