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General NPI Number Information
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NPI Number | 1750351235
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Entity Type | Individual
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Provider Name | LISA L COOPER APRN
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Gender | Female
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Dates
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Enumeration Date | 01/25/2006
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Last Update Date | 02/27/2017
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Provider Practice Location Address
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Address Line | 80 HIGHLAND ST LRGHEALTHCARE
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City | LACONIA
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State | NH
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Zip | 03246-3235
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Country | US
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Telephone | 603-524-3211
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Fax | 603-543-6950
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Provider Business Mailing Address
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Address Line | PO BOX 1327 LRGH PROFESSIONAL BILLING SERVICE
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City | LACONIA
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State | NH
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Zip | 03247-1327
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Country | US
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Telephone | 603-524-3211
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Fax | 603-527-7038
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 50504
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN248517 NP05747
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 070907-23
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License Number State | NH
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