| Tanya Marie Cooper, DNP, FNP-C | |
|
2361 Bison Ranch Trl # 4, Overgaard, AZ 85933-3277 | |
| (928) 251-2611 | |
| (877) 682-6177 |
| Full Name | Tanya Marie Cooper |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 2361 Bison Ranch Trl # 4, Overgaard, Arizona |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700151271 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | RN127927 (Arizona) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | AP4528 (Arizona) | Primary |
| Entity Name | North Country Healthcare Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073583472 PECOS PAC ID: 8820981053 Enrollment ID: O20040210001107 |
| Entity Name | Scottsdale Physicians Group Plc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1689799579 PECOS PAC ID: 8325099385 Enrollment ID: O20050207000876 |
| Mailing Address | Practice Location Address |
|---|---|
| Tanya Marie Cooper, DNP, FNP-C Po Box 1854, Overgaard, AZ 85933-1854 Ph: (928) 251-2611 | Tanya Marie Cooper, DNP, FNP-C 2361 Bison Ranch Trl # 4, Overgaard, AZ 85933-3277 Ph: (928) 251-2611 |
Timothy R Penniston, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2352 Quarter Horse Trl, Overgaard, AZ 85933 Phone: 928-535-3616 Fax: 928-532-2156 | |
Mr. Kelly Marcum, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2931 S Hwy 260, Overgaard, AZ 85933 Phone: 928-536-3616 Fax: 928-536-3615 |