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General NPI Number Information
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NPI Number | 1033193065
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Entity Type | Individual
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Provider Name | MELISSA E COOPER ARNP
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Gender | Female
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Dates
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Enumeration Date | 12/02/2005
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Last Update Date | 11/04/2020
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Provider Practice Location Address
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Address Line | 7475 MCLAUGHLIN RD
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City | PEYTON
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State | CO
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Zip | 80831-4716
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Country | US
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Telephone | 719-495-9994
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Fax |
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Provider Business Mailing Address
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Address Line | 1909 MEDICI LN
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City | COLORADO SPRINGS
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State | CO
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Zip | 80921-4196
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Country | US
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Telephone | 662-328-9623
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R718106
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APN.0994208-NP
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License Number State | CO
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