| Doctor Name: | JACQUELINE ROSE COOPER |
| NPI Number: | 1265719520 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN, CNP |
| License Number: | R204960-3 |
| Business Practice Address: | 2000 Klein St Saint Peter, MN - 560825800 |
| Business Phone Number: | 5079335001 |
| Business Fax Number: | 5079347043 |
| Mailing Address: | 2000 Klein St, SAINT PETER |
| State: | MN |
| Postal Code: | 560825800 |
| Phone Number: | 5079335001 |
| Fax Number: | 5079347043 |
| NPI Enumeration Date: | 11/14/2011 |
| NPI Last Update Date: | 11/03/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | R204960-3 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |