MEDICARE: MRS. KAREN ELIZABETH COOPER RN, NP-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	569012	TX

General Provider Information

NPI Number	:	1598015794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KAREN ELIZABETH COOPER RN, NP-C

Provider Business Mailing Address
First Line	:	6807 EMMETT F LOWRY EXPY STE 305
Second Line	:
City	:	TEXAS CITY
State	:	TX
Zip	:	77591-2548
Country	:	US
Telephone Number	:	409-934-8687
Fax Number	:	409-934-8689

Provider Business Practice Location Address
First Line	:	6807 EMMETT F LOWRY EXPY STE 305
Second Line	:
City	:	TEXAS CITY
State	:	TX
Zip	:	77591-2548
Country	:	US
Telephone Number	:	409-934-8687
Fax Number	:	409-934-8689

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

Provider Enumeration Date	:	09/14/2012
Last Update Date	:	09/14/2012

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