Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 1084979 | KY |
NPI | 1235107400 |
---|---|
Provider Name | Christine Kay Cooper |
First Address | Chicago, IL 60677-6351 |
Second Address | Louisville, KY 40207-4721 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 21/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000744517 | ANTHEM- KCNS (01) | KY |
200426780 | (05) | IN |
20046780 | IHCP INDIANA MEDICAID (01) | IN |
50035395 | PASSPORT- KCNS (01) | KY |
78013570 | (05) | KY |
Q28161 | (02) | KY |