Provider Demographics
NPI:1962960062
Name:COOPER, DEBRA ANN (APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:ANN
Last Name:COOPER
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8164 KINGVIEW ST
Mailing Address - Street 2:
Mailing Address - City:SAINT JAMES
Mailing Address - State:LA
Mailing Address - Zip Code:70086-7523
Mailing Address - Country:US
Mailing Address - Phone:225-806-5021
Mailing Address - Fax:
Practice Address - Street 1:7301 HENNESSY BLVD STE 3D
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4793
Practice Address - Country:US
Practice Address - Phone:225-526-4060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-07
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAF03190056363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily