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

Stacy Renee Cooper, NP

Individual provider Registered Nurse · NPI 1720844061

Stacy Renee Cooper, NP is a Nurse Practitioner in Columbus, Georgia. Qualified in 2023, 3 years ago. Practices with Providence Family Medicine Clinic, Inc, a 2-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
3
Licensed in
GA
In the registry since
2024
Specialties on file
2
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

5529 Rodgers Dr
Columbus, GA 31909-5426
Phone: (706) 405-9711
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 216057 (GA)
Registered Nurse Taxonomy 163W00000X · Licence 216057 (GA)

Record details

NPI number1720844061
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorYes
NPI enumeratedFebruary 26, 2024
Last updated in NPPESDecember 30, 2024
Certification dateDecember 24, 2024

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Providence Family Medicine Clinic, Inc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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