Cooper, Jeniesha

Cooper, Jeniesha is an individual health care provider with primary practice located at 1607 Barrington Vw , Stone Mountain GA 30087-1846. She recently has only one registered license in Nursing Service Providers / Licensed Practical Nurse, which is considered as her primary health care specialty. Cooper, Jeniesha can be contacted via phone (678) 582-9317.

Contact Information

Primary practice address
1607 Barrington Vw Stone Mountain GA 30087-1846
Phone: (678) 582-9317
Fax: (678) 705-3735
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X 27072457A Georgia

Profile Details

NPI number 1992447023
LBN Legal business name Cooper, Jeniesha
Credentials Licensed Practical Nurse (LPN)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 9th, 2022
Last updated Apr 9th, 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 1992447023 NPPES
Georgia MEDICAID 003258912A

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