Individual
AMY MARIE COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
73 QUARTERMASTER CT, JEFFERSONVILLE, IN 47130-3623
(812) 288-8360
(812) 288-8375
Mailing address
73 QUARTERMASTER CT, JEFFERSONVILLE, IN 47130-3623
(812) 288-8360
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71005460A
IN
363LF0000X
Family Nurse Practitioner
Primary
3009391
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001057810
ANTHEM
—
05
—
200153120
—
IN
05
—
7100373050
—
KY
Enumeration date
06/02/2015
Last updated
02/10/2017
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