Provider Demographics
NPI:1891873287
Name:COOPER, JULIET DENISE (RN)
Entity Type:Individual
Prefix:MRS
First Name:JULIET
Middle Name:DENISE
Last Name:COOPER
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3755 PEBBLE BEACH DRIVE
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30349
Mailing Address - Country:US
Mailing Address - Phone:770-964-3949
Mailing Address - Fax:
Practice Address - Street 1:265 BOULEVARD SE 4TH FLOOR
Practice Address - Street 2:FULTON COUNTY DEPT OF HEALTH AND WELLNESS
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312
Practice Address - Country:US
Practice Address - Phone:404-730-1636
Practice Address - Fax:404-730-1629
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN048947163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse