Provider Demographics
NPI:1619522521
Name:COOPER, BRITTANY LEANN (PHARMD)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:LEANN
Last Name:COOPER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9252 THREAVE LN APT 308
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38125-2477
Mailing Address - Country:US
Mailing Address - Phone:662-816-7179
Mailing Address - Fax:
Practice Address - Street 1:1011 GOODMAN RD E
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-9505
Practice Address - Country:US
Practice Address - Phone:662-349-6787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-07
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-16133183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist