Provider Demographics
NPI:1780323626
Name:COOPER, EMILY YAWMAN
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:YAWMAN
Last Name:COOPER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:YAWMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNPC
Mailing Address - Street 1:1400 S ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-2134
Mailing Address - Country:US
Mailing Address - Phone:321-841-1893
Mailing Address - Fax:407-425-5203
Practice Address - Street 1:9220 SABAL PALM CIR
Practice Address - Street 2:
Practice Address - City:WINDERMERE
Practice Address - State:FL
Practice Address - Zip Code:34786-8815
Practice Address - Country:US
Practice Address - Phone:480-371-7646
Practice Address - Fax:407-254-5988
Is Sole Proprietor?:No
Enumeration Date:2022-05-31
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11019126363L00000X
FLAPRN11019126363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner