Basic Information
| Provider Information | |||||||||
| NPI: | 1346356698 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COOPER | ||||||||
| FirstName: | MELISSA | ||||||||
| MiddleName: | PATTERSON | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | RN, CWOCN, DNC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 695 | ||||||||
| Address2: | 332 VALENICA AVE | ||||||||
| City: | EL GRANADA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940180695 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6507260173 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3801 MIRANDA AVE | ||||||||
| Address2: | 123 | ||||||||
| City: | PALO ALTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 943041207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6504935000 | ||||||||
| FaxNumber: | 6504962573 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/21/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WW0000X | 450306 | CA | Y | Nursing Service Providers | Registered Nurse | Wound Care |
No ID Information.