Individual provider · NPI-1
Kelley Cooper, RN
Registered Nurse, Home Health · Racine, WI
NPI number1679917728
StatusActive
Last updated in NPPESApr 19, 2013
Details
- NPI
- 1679917728
- Entity type
- Individual (NPI-1)
- Name
- Kelley Cooper
- Credential
- RN
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 19, 2013
- Last updated
- Apr 19, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163WH0200X | Registered Nurse, Home Health | 128596-30 | WI | Yes |
Practice location
2000 Domanik DrRacine, WI 53404-2910
Phone 262-633-4800
Mailing address
2000 Domanik DrRacine, WI 53404-2910
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