Individual
BILLY COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
234 GOODMAN ST, CINCINNATI, OH 45219-2364
(513) 558-5281
(513) 558-5791
Mailing address
PO BOX 636256, CENTRAL CREDENTIALING, CINCINNATI, OH 45263-6256
(513) 585-5505
(513) 585-5511
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
3003806
KY
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN CNP 17771
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100141600
—
KY
Enumeration date
01/11/2008
Last updated
06/09/2017
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