Individual
KRISTINE COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
22711 130TH AVE, LAURELTON, NY 11413-1354
(646) 207-8437
Mailing address
22711 130TH AVE, LAURELTON, NY 11413-1354
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F308199-1
NY
Other
Enumeration date
01/06/2018
Last updated
01/06/2018
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