Individual
HEIDI COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13450 N MERIDIAN ST STE 135, CARMEL, IN 46032-1473
(317) 582-9355
Mailing address
13450 N MERIDIAN ST STE 135, CARMEL, IN 46032-1473
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002820A
IN
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10002820A
IN STATE LICENSE
IN
01
—
Q00416535
RAILROAD MEDICARE
IN
Enumeration date
09/27/2019
Last updated
02/07/2024
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