Provider Demographics
NPI:1497358444
Name:COOMER, HANNAH LACHELE (FNP)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:LACHELE
Last Name:COOMER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 LAKECREST DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47201-1442
Mailing Address - Country:US
Mailing Address - Phone:128-371-0454
Mailing Address - Fax:
Practice Address - Street 1:9365 COUSELOR'S ROW
Practice Address - Street 2:SUITE 200
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240
Practice Address - Country:US
Practice Address - Phone:317-429-0120
Practice Address - Fax:317-800-7730
Is Sole Proprietor?:No
Enumeration Date:2020-11-20
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28230179A163W00000X
IN71010604A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse