Healthcare Provider Details

I. General information

NPI: 1457009342
Provider Name (Legal Business Name): STEPHANIE REHER COOPER PNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2022
Last Update Date: 01/10/2025
Certification Date: 01/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13700 PRIDE PORT HUDSON RD
PRIDE LA
70770-9200
US

IV. Provider business mailing address

5959 S SHERWOOD FOREST BLVD
BATON ROUGE LA
70816-6038
US

V. Phone/Fax

Practice location:
  • Phone: 225-654-7325
  • Fax: 225-570-2043
Mailing address:
  • Phone: 225-654-7325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number224313
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code363LS0200X
TaxonomySchool Nurse Practitioner
License Number224313
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: