Provider Demographics
NPI:1356451769
Name:COOPER, JANET KNAPP (NP)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:KNAPP
Last Name:COOPER
Suffix:
Gender:F
Credentials:NP
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 131
Mailing Address - Street 2:
Mailing Address - City:CLIFF
Mailing Address - State:NM
Mailing Address - Zip Code:88028-0131
Mailing Address - Country:US
Mailing Address - Phone:575-284-6870
Mailing Address - Fax:
Practice Address - Street 1:880 N COLORADO ST
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-3419
Practice Address - Country:US
Practice Address - Phone:480-820-0825
Practice Address - Fax:480-820-7863
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM69162363LP0808X
AZRN123378363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZQ54152Medicare UPIN
AZ106041Medicare ID - Type Unspecified