Healthcare Provider Details

I. General information

NPI: 1780013250
Provider Name (Legal Business Name): RACHEL COOPER PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2013
Last Update Date: 02/05/2026
Certification Date: 02/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 MEADOW DR
DANVILLE IN
46122-1415
US

IV. Provider business mailing address

255 MEADOW DR
DANVILLE IN
46122-1415
US

V. Phone/Fax

Practice location:
  • Phone: 317-745-5451
  • Fax: 317-745-0318
Mailing address:
  • Phone: 317-745-5451
  • Fax: 317-745-0318

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number06003335A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: