Healthcare Provider Details

I. General information

NPI: 1861868531
Provider Name (Legal Business Name): KATHERINE COOPER NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHERINE PEREIRA NP-C

II. Dates (important events)

Enumeration Date: 08/18/2015
Last Update Date: 12/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

241 ELM STREET
CLAREMONT NH
03743-2099
US

IV. Provider business mailing address

243 ELM STREET
CLAREMONT NH
03743-2099
US

V. Phone/Fax

Practice location:
  • Phone: 603-543-6900
  • Fax: 603-542-9497
Mailing address:
  • Phone: 603-543-6900
  • Fax: 603-542-9497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number071563-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: