Provider Demographics
NPI:1992182117
Name:ANDREWS-COOPER, IQUO (FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:IQUO
Middle Name:
Last Name:ANDREWS-COOPER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:IQUO
Other - Middle Name:
Other - Last Name:ANDREWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:500 EDGEWOOD RD STE 210
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:21040-2734
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:500 EDGEWOOD RD STE 210
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:MD
Practice Address - Zip Code:21040-2734
Practice Address - Country:US
Practice Address - Phone:443-402-0172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-27
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR175457363LF0000X
MDF0811105363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDVAD000Medicare UPIN