Provider Demographics
NPI:1447032073
Name:COOPER, KAREN SUE
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:SUE
Last Name:COOPER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:892 SULPHER LICK RD
Mailing Address - Street 2:
Mailing Address - City:WEST PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45663-9238
Mailing Address - Country:US
Mailing Address - Phone:740-352-7022
Mailing Address - Fax:
Practice Address - Street 1:892 SULPHER LICK RD
Practice Address - Street 2:
Practice Address - City:WEST PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45663-9238
Practice Address - Country:US
Practice Address - Phone:740-352-7022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide