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NPI Code Detail

MEDICARE: MR. KINARD COOPER APRN

MEDICARE: MR. KINARD COOPER APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerARNP9330825FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700323789
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. KINARD COOPER APRN
Provider Business Mailing Address
First Line : PO BOX 1137
Second Line :
City : MELBOURNE
State : FL
Zip : 32902-1137
Country : US
Telephone Number : 321-952-9696
Fax Number : 321-952-7937
Provider Business Practice Location Address
First Line : 17 SILVER PALM AVE
Second Line :
City : MELBOURNE
State : FL
Zip : 32901-3123
Country : US
Telephone Number : 321-241-6800
Fax Number : 321-241-6890
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2017
Last Update Date : 08/03/2023

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