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General NPI Number Information
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NPI Number | 1720109846
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Entity Type | Individual
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Provider Name | TAMMY LYVONNE COOPER APN-C
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Gender | Female
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 12/21/2023
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Provider Practice Location Address
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Address Line | 12522 GREAT PARK CIR #303
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City | GERMANTOWN
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State | MD
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Zip | 20876
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Country | US
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Telephone | 240-301-4866
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2718
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City | GERMANTOWN
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State | MD
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Zip | 20875-2718
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Country | US
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Telephone | 240-301-4866
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Fax | 848-213-0287
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 26NJ00372800
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | 26NR11441600
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 26NR11441600
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | R233355
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License Number State | MD
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Taxonomy #5
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | NP500005960
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License Number State | DC
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