Provider Demographics
NPI:1518040625
Name:COOPER, ROBIN L (NP)
Entity Type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:L
Last Name:COOPER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:3715 S MADISON ST
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47302-5756
Mailing Address - Country:US
Mailing Address - Phone:765-281-4263
Mailing Address - Fax:765-213-2769
Practice Address - Street 1:806 W JACKSON ST
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47305-1551
Practice Address - Country:US
Practice Address - Phone:765-281-4263
Practice Address - Fax:765-213-2769
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN28116772A363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health