Provider Demographics
NPI:1851180822
Name:COOPER, KRISTEN STAZHIA (RN)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:STAZHIA
Last Name:COOPER
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:STAZHIA
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6590 HEBER SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:LOCUST GROVE
Mailing Address - State:AR
Mailing Address - Zip Code:72550-9710
Mailing Address - Country:US
Mailing Address - Phone:870-262-9009
Mailing Address - Fax:
Practice Address - Street 1:404 LLAMA DR
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-4785
Practice Address - Country:US
Practice Address - Phone:501-268-2292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR121845163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health