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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

AUDREY COOPER

Active Sole Proprietor

AUDREY COOPER is a Physician Assistant healthcare provider located in TUSTIN, Michigan. NPI 1003407867 is currently active in the NPPES registry. Verify at CMS.

Physician Assistant · TUSTIN, MI

Registration Details

NPI Number
1003407867
Provider Type
Individual
Gender
Female
NPI Issued
Feb 3, 2021 (5.5600321769847 yrs)
Last Updated
Oct 28, 2025
Sole Proprietor
Yes

Practice Information

Address
22560 130TH AVE
TUSTIN, MI, 496888565
Browse MI providers · Browse ZIP 49688
Phone
2312061626
Primary Specialty
Physician Assistant
363A00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.