Provider Demographics
NPI:1053038638
Name:COOPER, DARBY ELISABETH (PA)
Entity type:Individual
Prefix:
First Name:DARBY
Middle Name:ELISABETH
Last Name:COOPER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:DARBY
Other - Middle Name:ELISABETH
Other - Last Name:BUNCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:125 MEDICAL PARK LN STE H
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:NC
Mailing Address - Zip Code:28906-6921
Mailing Address - Country:US
Mailing Address - Phone:865-405-9457
Mailing Address - Fax:
Practice Address - Street 1:125 MEDICAL PARK LN STE H
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:NC
Practice Address - Zip Code:28906-6921
Practice Address - Country:US
Practice Address - Phone:828-837-3525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-24
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-12737363AM0700X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical