Healthcare Provider Details

I. General information

NPI: 1841104767
Provider Name (Legal Business Name): AUDREY COOPER DNP APRN AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 N SAINT JOSEPH AVE
HASTINGS NE
68901-4451
US

IV. Provider business mailing address

1319 CRANE AVE
HASTINGS NE
68901-2826
US

V. Phone/Fax

Practice location:
  • Phone: 303-746-6620
  • Fax:
Mailing address:
  • Phone: 303-746-6620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number117238
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: