Barendina Yolanda Cooper, LPN
Individual provider Active NPI Licensed Practical Nurse · Sodus Point, NY
NPI 1013081306 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1013081306
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 221642 (NY)
- Practice address
- 8326 Lake St
Sodus Point, NY 14555-9613 - Phone
- (315) 483-2130
- NPI assigned
- Nov 20, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 221642 | NY | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 221642 | NY | Yes |
Addresses
Primary practice location
8326 Lake St
Sodus Point, NY 14555-9613
Mailing address
8326 Lake St
Sodus Point, NY 14555-9613
Phone (315) 483-2130
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01656582 | Medicaid | NY |
Other providers in Sodus Point, NY
All providers in Sodus Point, NY · Licensed Practical Nurse in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.