Provider Demographics
NPI:1972080281
Name:COOPER, JULIA (LPN)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:COOPER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8784 RAY CT APT 8
Mailing Address - Street 2:
Mailing Address - City:TWINSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44087-2079
Mailing Address - Country:US
Mailing Address - Phone:440-494-1765
Mailing Address - Fax:
Practice Address - Street 1:8784 RAY CT APT 8
Practice Address - Street 2:
Practice Address - City:TWINSBURG
Practice Address - State:OH
Practice Address - Zip Code:44087-2079
Practice Address - Country:US
Practice Address - Phone:440-494-1765
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-20
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.166852.MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHLPN.166852.MEDS-IVOtherLICENSE NUMBER
OHLPN.166852.MEDS-IVOtherOHIO B.O.N. LICENSE NUMBER