Provider Demographics
NPI:1487007829
Name:COOPER, BRITTANY LEIGH (FNP)
Entity Type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:LEIGH
Last Name:COOPER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:LEIGH
Other - Last Name:EASLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2350 HOUSTON LAKE RD
Mailing Address - Street 2:APT 1602
Mailing Address - City:KATHLEEN
Mailing Address - State:GA
Mailing Address - Zip Code:31047-5403
Mailing Address - Country:US
Mailing Address - Phone:478-955-3722
Mailing Address - Fax:
Practice Address - Street 1:1115 MORNINGSIDE DR
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:GA
Practice Address - Zip Code:31069-2905
Practice Address - Country:US
Practice Address - Phone:478-988-3060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-21
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN215936363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily