Individual
CHRISTINA COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
415 6TH ST, LEWISTON, ID 83501-2434
(208) 743-7612
(208) 746-4802
Mailing address
415 6TH STREET, ATTN: PHYSICIAN SERVICES, LEWISTON, ID 83501-2434
(208) 750-7462
(208) 750-7467
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
66771-CNP
ID
363LF0000X
Family Nurse Practitioner
CNP02119
NM
Other
Enumeration date
12/06/2012
Last updated
12/26/2024
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