Provider Demographics
NPI:1427862952
Name:COOPER, LUKE ANTHONY
Entity type:Individual
Prefix:
First Name:LUKE
Middle Name:ANTHONY
Last Name:COOPER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 WESTMORELAND ST
Mailing Address - Street 2:
Mailing Address - City:HARROGATE
Mailing Address - State:TN
Mailing Address - Zip Code:37752-8202
Mailing Address - Country:US
Mailing Address - Phone:423-441-8011
Mailing Address - Fax:
Practice Address - Street 1:165 WESTMORELAND ST
Practice Address - Street 2:
Practice Address - City:HARROGATE
Practice Address - State:TN
Practice Address - Zip Code:37752-8202
Practice Address - Country:US
Practice Address - Phone:423-441-8011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38108363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily