Provider Demographics
NPI:1205137270
Name:COOPER, JANET LEE (CNP)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:LEE
Last Name:COOPER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1340 HAL GREER BLVD
Mailing Address - Street 2:ATTN: T. SILVA
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-3800
Mailing Address - Country:US
Mailing Address - Phone:304-399-6727
Mailing Address - Fax:304-399-6726
Practice Address - Street 1:1340 HAL GREER BLVD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-3800
Practice Address - Country:US
Practice Address - Phone:304-399-6727
Practice Address - Fax:304-399-6726
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-08
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA 11727363LF0000X
WVAPRN86017-NP-C363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily