Provider Demographics
NPI:1881988509
Name:COOPER, DEBORAH (CNA)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:COOPER
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34652 N US HIGHWAY 281
Mailing Address - Street 2:
Mailing Address - City:LIPAN
Mailing Address - State:TX
Mailing Address - Zip Code:76462-7070
Mailing Address - Country:US
Mailing Address - Phone:214-517-6610
Mailing Address - Fax:
Practice Address - Street 1:34652 N US HIGHWAY 281
Practice Address - Street 2:
Practice Address - City:LIPAN
Practice Address - State:TX
Practice Address - Zip Code:76462-7070
Practice Address - Country:US
Practice Address - Phone:214-517-6610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-31
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide