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General NPI Number Information
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NPI Number | 1548930571
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Entity Type | Organization
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Legal Business Name | CARESTOP LLC
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Dates
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Enumeration Date | 09/21/2021
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Last Update Date | 09/10/2024
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Provider Practice Location Address
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Address Line | 335 MARGIE DR STE F
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City | WARNER ROBINS
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State | GA
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Zip | 31088-8908
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Country | US
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Telephone | 478-227-4051
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2254
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City | BYRON
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State | GA
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Zip | 31008-2254
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Country | US
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Telephone | 478-765-2888
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TERRILL ANTHONY COOPER
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Credential | FNP-C, PMHNP-BC
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Telephone | 478-227-4051
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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