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General NPI Number Information
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NPI Number | 1780719781
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Entity Type | Individual
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Provider Name | LINDA TATKO COOPER NP-C
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Gender | Female
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1295 STATE ST C 340
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City | SPRINGFIELD
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State | MA
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Zip | 01111-0001
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Country | US
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Telephone | 413-744-5836
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Fax |
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Provider Business Mailing Address
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Address Line | 225 MAYNARD RD
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City | WILBRAHAM
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State | MA
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Zip | 01095-1211
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Country | US
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Telephone | 413-599-0218
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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 | 145547
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 003342
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License Number State | CT
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