Provider Demographics
NPI:1922405422
Name:COOPER, RACHEL LORRAINE (RN)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:LORRAINE
Last Name:COOPER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7374 CADY RD
Mailing Address - Street 2:
Mailing Address - City:NORTH ROYALTON
Mailing Address - State:OH
Mailing Address - Zip Code:44133-6334
Mailing Address - Country:US
Mailing Address - Phone:216-339-6268
Mailing Address - Fax:
Practice Address - Street 1:7594 MURRAY AVE
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-6028
Practice Address - Country:US
Practice Address - Phone:440-622-4727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-26
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN92371164W00000X, 164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No164W00000XNursing Service ProvidersLicensed Practical Nurse