Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0216X | Pediatric Rheumatologist | 04-36514 | KS |
Y | 2080P0216X | Pediatric Rheumatologist | 2013017436 | MO |
NPI | 1740485721 |
---|---|
Provider Name | Ashley M Cooper |
First Address | Kansas City, MO 64108-4619 |
Second Address | Kansas City, MO 64108-4619 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2007 |
Last Update Date | 21/08/2013 |