| Doctor Name: | MS. SANDRA M COOPER |
| NPI Number: | 1750614483 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CRNP |
| License Number: | SP010119 |
| Business Practice Address: | 5479 Pottsville Pike Leesport, PA - 195338633 |
| Business Phone Number: | 6109161050 |
| Business Fax Number: | |
| Mailing Address: | 2442 Brodhead Rd, BETHLEHEM |
| State: | PA |
| Postal Code: | 180208910 |
| Phone Number: | 6107588011 |
| Fax Number: | 6107588013 |
| NPI Enumeration Date: | 09/14/2009 |
| NPI Last Update Date: | 05/02/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | SP010119 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |