Stacy Renee Cooper, NP | |
5529 Rodgers Dr, Columbus, GA 31909-5426 | |
(706) 405-9711 | |
Not Available |
Full Name | Stacy Renee Cooper |
---|---|
Gender | Female |
Speciality | Nurse Practitioner - Family |
Location | 5529 Rodgers Dr, Columbus, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1720844061 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
163W00000X | Registered Nurse | 216057 (Georgia) | Secondary |
363LF0000X | Nurse Practitioner - Family | 216057 (Georgia) | Primary |
Entity Name | Providence Family Medicine Clinic, Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1346590148 PECOS PAC ID: 7719138577 Enrollment ID: O20121105000262 |
Mailing Address | Practice Location Address |
---|---|
Stacy Renee Cooper, NP 5529 Rodgers Dr, Columbus, GA 31909-5426 Ph: (706) 405-9711 | Stacy Renee Cooper, NP 5529 Rodgers Dr, Columbus, GA 31909-5426 Ph: (706) 405-9711 |
Resa A Lord, CPNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 705 17th St, Suite 107, Columbus, GA 31901 Phone: 706-571-1665 Fax: 706-660-2699 | |
Courtni Schaaf, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2000 10th Ave Ste 370, Columbus, GA 31901 Phone: 706-660-2562 Fax: 706-660-2580 | |
Ms. April Allen, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4343 Warm Springs Rd Apt 2104, Columbus, GA 31909 Phone: 706-536-4775 | |
Brandi Michelle Richards, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 6600 Whittlesey Blvd Ste A, Columbus, GA 31909 Phone: 706-321-0476 | |
Susan Carol Wieczorek, NP-C, CWOCN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 808 21st St, Columbus, GA 31904 Phone: 706-321-3901 Fax: 706-321-3904 | |
Mrs. Ann Marie Blair, NP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 610 19th St, Columbus, GA 31901 Phone: 706-322-7884 | |
Mrs. Crystal Berry, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 611 Brown Ave, Columbus, GA 31906 Phone: 678-729-7973 |