Individual
KIMBERLY ANN COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01087306A
IN
208000000X
Pediatrics Physician
34012820
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0226978
—
OH
05
—
2367501
—
LA
Enumeration date
07/09/2014
Last updated
05/18/2022
Update your record
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