Provider Demographics
NPI:1699569400
Name:COOPER, PAIGE E (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:PAIGE
Middle Name:E
Last Name:COOPER
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:MRS
Other - First Name:PAIGE
Other - Middle Name:E
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4895 DIGGINS DR
Mailing Address - Street 2:
Mailing Address - City:FORT GEORGE G MEADE
Mailing Address - State:MD
Mailing Address - Zip Code:20755-2142
Mailing Address - Country:US
Mailing Address - Phone:615-580-5106
Mailing Address - Fax:
Practice Address - Street 1:4201 NORTHVIEW DR STE 410
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-2668
Practice Address - Country:US
Practice Address - Phone:615-580-5106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDACOO7567207Q00000X
VA0024192980207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine