Healthcare Provider Details

I. General information

NPI: 1780183723
Provider Name (Legal Business Name): BRITTANY L COOPER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2018
Last Update Date: 02/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ELLIOT WAY
MANCHESTER NH
03103-3502
US

IV. Provider business mailing address

10 COOPER LN APT 311
BEDFORD NH
03110-6082
US

V. Phone/Fax

Practice location:
  • Phone: 603-669-5300
  • Fax:
Mailing address:
  • Phone: 603-494-5500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number066466-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: