Healthcare Provider Details

I. General information

NPI: 1508789736
Provider Name (Legal Business Name): HANNAH COOPER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 S HEBER ST
BECKLEY WV
25801-5423
US

IV. Provider business mailing address

190 HIDDEN MEADOWS LN
PRINCETON WV
24740-8828
US

V. Phone/Fax

Practice location:
  • Phone: 681-238-6412
  • Fax:
Mailing address:
  • Phone: 304-890-8366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: