Provider Demographics
NPI:1386495588
Name:COOPER, JULIA KAILING
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:KAILING
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 1:1056 HERITAGE DR
Mailing Address - Street 2:
Mailing Address - City:SALINE
Mailing Address - State:MI
Mailing Address - Zip Code:48176-1074
Mailing Address - Country:US
Mailing Address - Phone:734-260-5791
Mailing Address - Fax:
Practice Address - Street 1:1056 HERITAGE DR
Practice Address - Street 2:
Practice Address - City:SALINE
Practice Address - State:MI
Practice Address - Zip Code:48176-1074
Practice Address - Country:US
Practice Address - Phone:734-260-5791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide