MEDICARE: MARTA COOPER FNP-BC, APNP

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
1	363LF0000X	Family Nurse Practitioner	921833	WI

General Provider Information

NPI Number	:	1942865365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARTA COOPER FNP-BC, APNP

Provider Business Mailing Address
First Line	:	101 E MILWAUKEE ST STE 315
Second Line	:
City	:	JANESVILLE
State	:	WI
Zip	:	53545-3002
Country	:	US
Telephone Number	:	608-305-0201
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 E MILWAUKEE ST STE 315
Second Line	:
City	:	JANESVILLE
State	:	WI
Zip	:	53545-3002
Country	:	US
Telephone Number	:	608-305-0201
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/02/2019
Last Update Date	:	09/23/2025

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