Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Audrey Cooper

Individual provider Physician Assistant · NPI 1003407867

Audrey Cooper is a Physician Assistant in Tustin, Michigan. Qualified in 2021, 5 years ago. Practices with Peterson Medical Clinics LLC, a 89-clinician group, accepts Medicare assignment and offers telehealth.

Years since qualifying
5
In the registry since
2021

Practice location Address checks out

22560 130th Ave
Tustin, MI 49688-8565
Phone: (231) 206-1626
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1003407867
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedFebruary 3, 2021
Last updated in NPPESOctober 28, 2025
Certification dateOctober 28, 2025
Mailing address22560 130th Ave, Tustin, MI 49688-8565

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Peterson Medical Clinics Llc — 89 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations5 on file with Medicare

Other providers in Tustin