Provider Demographics
NPI:1205007473
Name:COOPER, RAYLYNNE J (CNA)
Entity Type:Individual
Prefix:MS
First Name:RAYLYNNE
Middle Name:J
Last Name:COOPER
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 E 300 S
Mailing Address - Street 2:
Mailing Address - City:LOA
Mailing Address - State:UT
Mailing Address - Zip Code:84747-0534
Mailing Address - Country:US
Mailing Address - Phone:435-836-3600
Mailing Address - Fax:435-836-3600
Practice Address - Street 1:175 E 300 S
Practice Address - Street 2:
Practice Address - City:LOA
Practice Address - State:UT
Practice Address - Zip Code:84747-0534
Practice Address - Country:US
Practice Address - Phone:435-836-3600
Practice Address - Fax:435-836-3600
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-17
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker