Provider Demographics
NPI:1679533061
Name:COOPER, BARBARA E (CNM)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:E
Last Name:COOPER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5940 N LA CHOLLA BLVD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85741-3535
Mailing Address - Country:US
Mailing Address - Phone:520-219-5779
Mailing Address - Fax:520-219-5780
Practice Address - Street 1:5940 N LA CHOLLA BLVD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-3535
Practice Address - Country:US
Practice Address - Phone:520-219-5779
Practice Address - Fax:520-219-5780
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN069053367A00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ723463Medicaid
R94236Medicare UPIN