Provider Demographics
NPI:1871929711
Name:COOPER, ALICIA (PA)
Entity type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:
Last Name:COOPER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:
Other - Last Name:HOTCHKISS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:PO BOX 9196
Mailing Address - Street 2:WVU RUBY MEMORIAL HOSPITAL
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26506
Mailing Address - Country:US
Mailing Address - Phone:304-293-3908
Mailing Address - Fax:
Practice Address - Street 1:ROOM 3400 HSS
Practice Address - Street 2:WVU RUBY MEMORIAL HOSPITAL
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26506
Practice Address - Country:US
Practice Address - Phone:304-293-3908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-24
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant