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General NPI Number Information
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NPI Number | 1407995798
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Entity Type | Individual
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Provider Name | KATHRYN H COOPER CRNA
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Gender | Female
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1874 BELTLINE RD SW
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City | DECATUR
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State | AL
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Zip | 35601-5514
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Country | US
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Telephone | 256-301-3340
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Fax | 256-301-3443
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Provider Business Mailing Address
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Address Line | 157 COUNTY ROAD 378
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City | TRINITY
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State | AL
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Zip | 35673-5346
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Country | US
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Telephone | 256-355-5169
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 44289
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License Number State | AL
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