Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 51360 | KY |
N | 2080P0204X | Pediatric Emergency Doctor | 59357 | MN |
NPI | 1144589292 |
---|---|
Provider Name | Gena Lynn Cooper |
First Address | Lexington, KY 40536-0298 |
Second Address | Lexington, KY 40536-0298 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2012 |
Last Update Date | 22/06/2018 |