Individual provider · Type 1 NPI
Dyan Renee Cooper, PNP
Pediatric Nurse Practitioner · St. Louis, MO
NPI number
1578739124
Active
Practice location
1 Childrens Pl, Div Ped Neurological Surgery, Ste 4E
St. Louis, MO 63110-1002
Fax (314) 454-2816
Mailing address
PO Box 7412011
Chicago, IL 60674-2011
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Nurse Practitioner Primary | 363LP0200X | 2007036004 (MO) |
Pediatric Nurse Practitioner: Definition to come...
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About NPI 1578739124
Dyan Renee Cooper, PNP's National Provider Identifier is 1578739124, issued on May 5, 2008. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in St. Louis, MO. The record was last updated on Apr 17, 2025.