Basic Information
| Provider Information | |||||||||
| NPI: | 1760862478 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COOPER | ||||||||
| FirstName: | LAUREN | ||||||||
| MiddleName: | NICOLE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2311 LARK ST | ||||||||
| Address2: | |||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701224319 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3105089329 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1202 S TYLER ST | ||||||||
| Address2: | |||||||||
| City: | COVINGTON | ||||||||
| State: | LA | ||||||||
| PostalCode: | 704332330 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9858984000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/08/2015 | ||||||||
| LastUpdateDate: | 07/26/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/26/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 154157 | CA | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 125066872 | IL | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 322023 | LA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.