Cheryl Cooper, PMHNP | |
1200 N State St, Jackson, MS 39202-2000 | |
(601) 957-7343 | |
Not Available |
Full Name | Cheryl Cooper |
---|---|
Gender | Female |
Speciality | Nurse Practitioner - Psychiatric/mental Health |
Location | 1200 N State St, Jackson, Mississippi |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1174302830 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 906185 (Mississippi) | Primary |
Entity Name | Pathway Healthcare- Mississippi Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1013425503 PECOS PAC ID: 3779844774 Enrollment ID: O20180308001891 |
Mailing Address | Practice Location Address |
---|---|
Cheryl Cooper, PMHNP 475 Lowe Cir, Richland, MS 39218-9721 Ph: (769) 798-7229 | Cheryl Cooper, PMHNP 1200 N State St, Jackson, MS 39202-2000 Ph: (601) 957-7343 |
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