MEDICARE: AUDREA COOPER FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	F06250589	IN

General Provider Information

NPI Number	:	1578436606
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUDREA COOPER FNP-C

Provider Business Mailing Address
First Line	:	2101 N GREEN RIVER RD
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47715-2942
Country	:	US
Telephone Number	:	812-901-5770
Fax Number	:

Provider Business Practice Location Address
First Line	:	2101 N GREEN RIVER RD STE 1
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47715-2942
Country	:	US
Telephone Number	:	812-901-5770
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/25/2025
Last Update Date	:	09/30/2025

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Directions to “ AUDREA COOPER FNP-C” Practice Location

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