| Jenna Nicole Cooper, | |
|
200 E Ryan Rd, Oak Creek, WI 53154-4563 | |
| (414) 570-3590 | |
| Not Available |
| Full Name | Jenna Nicole Cooper |
|---|---|
| Gender | Female |
| Speciality | Speech-language Pathologist |
| Location | 200 E Ryan Rd, Oak Creek, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205684669 | NPI | - | NPPES |
| 100279167 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | 6601-154 (Wisconsin) | Primary |
| Provider Name | Aurora Medical Group, Inc. |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1427271378 PECOS PAC ID: 6709794258 Enrollment ID: O20031105000725 |
| Provider Name | Lakeshore Medical Clinic Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1003861188 PECOS PAC ID: 7719890730 Enrollment ID: O20031106000481 |
| Provider Name | Aurora Advanced Healthcare Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1265629133 PECOS PAC ID: 3375625833 Enrollment ID: O20080123000694 |
| Mailing Address | Practice Location Address |
|---|---|
| Jenna Nicole Cooper, 9070 S Chicago Ct, Oak Creek, WI 53154-4243 Ph: (414) 430-2117 | Jenna Nicole Cooper, 200 E Ryan Rd, Oak Creek, WI 53154-4563 Ph: (414) 570-3590 |
Michelle Kondrat, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 140 E Rawson Ave Ste 317, Oak Creek, WI 53154 Phone: 262-287-0090 | |
Laura Whiteside, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 140 E Rawson Ave Ste 317, Oak Creek, WI 53154 Phone: 262-287-0090 | |
Nicole Marie Mcgillicuddy, Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 2700 W Honadel Blvd, Oak Creek, WI 53154 Phone: 414-435-2005 | |
Rachelle Verhulst, MA, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 140 E Rawson Ave, Ste 317, Oak Creek, WI 53154 Phone: 262-287-0090 | |
Chloe Elizabeth Nolan Shoup, SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 140 E Rawson Ave Ste 317, Oak Creek, WI 53154 Phone: 262-287-0090 | |
Robin K Hecox, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 140 E Rawson Ave Ste 317, Oak Creek, WI 53154 Phone: 262-287-0090 |