Healthcare Provider Details

I. General information

NPI: 1619588043
Provider Name (Legal Business Name): RANA COOPER FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2020
Last Update Date: 05/14/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1265 UNION AVE 2 SHORB TOWER
MEMPHIS TN
38104
US

IV. Provider business mailing address

1211 UNION AVE STE 330
MEMPHIS TN
38104-6655
US

V. Phone/Fax

Practice location:
  • Phone: 901-478-5330
  • Fax: 901-478-8358
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number27411
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: