Individual
KELLY ANN COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
401 E CHESTNUT ST UNIT 310, LOUISVILLE, KY 40202-5703
(502) 588-4710
(502) 588-4771
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 588-0325
(502) 588-0326
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3011536
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300006974
—
IN
Enumeration date
07/06/2017
Last updated
07/21/2022
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