Individual
AMY L. COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 E IDAHO ST, BOISE, ID 83712-6267
(208) 381-4171
(208) 381-4172
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
(208) 381-4172
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
38992
KY
207VX0000X
Obstetrics Physician
38992
KY
207VX0201X
Gynecologic Oncology Physician
Primary
M9920
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64082670
—
KY
Enumeration date
06/16/2006
Last updated
10/28/2012
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