Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 201150171NP | OR |
N | 363LA2200X | Nurse Practitioner - Adult Health | COA.11762-NP | OH |
NPI | 1023324415 |
---|---|
Provider Name | Mrs. Kara Marie Cooper |
First Address | Hillsboro, OR 97123 |
Second Address | Forest Grove, OR 97116 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2010 |
Last Update Date | 28/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
R172384 | (02) | OR |