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NPI Code Detail

MEDICARE: MS. RHONDA DENISE COOPER RN

MEDICARE: MS. RHONDA DENISE COOPER RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN185227GA

General Provider Information

NPI Number : 1356584304
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. RHONDA DENISE COOPER RN
Provider Business Mailing Address
First Line : 6315 GARDEN WALK BLVD
Second Line :
City : RIVERDALE
State : GA
Zip : 30274-2628
Country : US
Telephone Number : 770-991-7420
Fax Number : 770-991-7429
Provider Business Practice Location Address
First Line : 6315 GARDEN WALK BLVD
Second Line :
City : RIVERDALE
State : GA
Zip : 30274-2628
Country : US
Telephone Number : 770-991-7420
Fax Number : 770-991-7429
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2009
Last Update Date : 04/07/2009

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Directions to “ MS. RHONDA DENISE COOPER RN” Practice Location

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