Individual
KAYLA COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1325 SPRING ST, GREENWOOD, SC 29646-3860
(864) 725-4111
Mailing address
354 S MARKET ST, ELYSBURG, PA 17824-9753
(570) 850-5780
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
20727
SC
367500000X
Certified Registered Nurse Anesthetist
Primary
RN614980
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1032778540001
—
PA
Enumeration date
04/21/2016
Last updated
03/15/2024
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