Provider Demographics
NPI:1184356727
Name:COOPER, ASHLEY CHEREE
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:CHEREE
Last Name:COOPER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 CHARDONAY DR
Mailing Address - Street 2:
Mailing Address - City:MAXTON
Mailing Address - State:NC
Mailing Address - Zip Code:28364-9171
Mailing Address - Country:US
Mailing Address - Phone:910-691-1228
Mailing Address - Fax:
Practice Address - Street 1:54 CHARDONAY DR
Practice Address - Street 2:
Practice Address - City:MAXTON
Practice Address - State:NC
Practice Address - Zip Code:28364-9171
Practice Address - Country:US
Practice Address - Phone:910-691-1228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-30
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker