Cooper, Jacqueline

Cooper, Jacqueline is an sole proprietor health care provider with primary practice located at 212 Lot1 County Rd 331 , Houston MS 38851. She recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Home Health, Nursing Service Related Providers / Home Health Aide, Nursing Service Providers / Registered Nurse. Nursing Service Providers / Registered Nurse is her primary health care specialty. Cooper, Jacqueline can be contacted via phone (662) 542-9440.

Contact Information

Primary practice address
212 Lot1 County Rd 331 Houston MS 38851
Phone: (662) 542-9440
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Home Health 163WH0200X 895548 Mississippi
Nursing Service Related Providers / Home Health Aide 374U00000X 895548 Mississippi
Nursing Service Providers / Registered Nurse 163W00000X 895548 Mississippi

Profile Details

NPI number 1023742681
LBN Legal business name Cooper, Jacqueline
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 11th, 2022
Last updated Jul 11th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023742681 NPPES
Mississippi Other 863785168 MEDICARE
Mississippi MEDICAID 863785168 MEDICARE

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