Healthcare Provider Details

I. General information

NPI: 1255240925
Provider Name (Legal Business Name): NAKIA COOPER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1075 PEACHTREE ST NE # 570484
ATLANTA GA
30309-3912
US

IV. Provider business mailing address

1075 PEACHTREE ST NE # 570484
ATLANTA GA
30309-3912
US

V. Phone/Fax

Practice location:
  • Phone: 800-974-1606
  • Fax:
Mailing address:
  • Phone: 800-974-1606
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: