Individual provider · Type 1 NPI
Stacy Cooper, PA-C
Medical Physician Assistant · Blackfoot, ID
NPI number
1518157544
Active
Practice location
98 Poplar St
Blackfoot, ID 83221-1758
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | PA648 (ID) |
Medical Physician Assistant: Definition to come...
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Other medical physician assistant providers in Blackfoot
About NPI 1518157544
Stacy Cooper, PA-C's National Provider Identifier is 1518157544, issued on Jul 26, 2007. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Blackfoot, ID. The record was last updated on May 1, 2009.