Individual
CHRISTINE KAY COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
4123 DUTCHMANS LN, SUITE 301, LOUISVILLE, KY 40207-4721
(502) 896-2500
(502) 896-2527
Mailing address
PO BOX 766351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
1084979
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000744517
ANTHEM- KCNS
KY
05
—
200426780
—
IN
01
—
20046780
IHCP INDIANA MEDICAID
IN
01
—
50035395
PASSPORT- KCNS
KY
05
—
78013570
—
KY
Enumeration date
03/14/2006
Last updated
07/21/2016
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