Provider Demographics
NPI:1396730677
Name:COOPER, JANE M (RN BC FNP)
Entity type:Individual
Prefix:MRS
First Name:JANE
Middle Name:M
Last Name:COOPER
Suffix:
Gender:F
Credentials:RN BC FNP
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Mailing Address - Street 1:PO BOX 843966
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64184-3966
Mailing Address - Country:US
Mailing Address - Phone:573-884-3300
Mailing Address - Fax:573-884-0943
Practice Address - Street 1:303 N KEENE ST STE 401
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-8054
Practice Address - Country:US
Practice Address - Phone:573-884-2200
Practice Address - Fax:573-874-8737
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2021-01-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO074850363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO425251501Medicaid
MOP02993Medicare UPIN
MO000081119Medicare PIN