Provider Demographics
NPI:1114273059
Name:SNOBER-COOPER, NANCY
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:SNOBER-COOPER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8833 PERIMETER PARK BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-1111
Mailing Address - Country:US
Mailing Address - Phone:904-997-1100
Mailing Address - Fax:
Practice Address - Street 1:8833 PERIMETER PARK BLVD STE 203
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-1111
Practice Address - Country:US
Practice Address - Phone:904-997-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-30
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9247560363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily