Healthcare Provider Details

I. General information

NPI: 1568387900
Provider Name (Legal Business Name): SAMANTHA COOPER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 W GARFIELD RD
AURORA OH
44202-8821
US

IV. Provider business mailing address

2037 W 25TH ST STE 1
CLEVELAND OH
44113-4113
US

V. Phone/Fax

Practice location:
  • Phone: 330-562-7032
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0043137
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: