Provider Demographics
NPI:1861964447
Name:COOPER, AMANDA B (APRN, FNP)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:B
Last Name:COOPER
Suffix:
Gender:F
Credentials:APRN, FNP
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:BETH
Other - Last Name:DUNAVANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1710 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-7303
Mailing Address - Country:US
Mailing Address - Phone:870-262-5545
Mailing Address - Fax:870-262-6966
Practice Address - Street 1:197 HOSPITAL DR STE B
Practice Address - Street 2:
Practice Address - City:CHEROKEE VILLAGE
Practice Address - State:AR
Practice Address - Zip Code:72529-7315
Practice Address - Country:US
Practice Address - Phone:870-257-5118
Practice Address - Fax:870-257-6215
Is Sole Proprietor?:No
Enumeration Date:2018-12-20
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA006034363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR232524758Medicaid