Provider Demographics
NPI:1679818660
Name:COOPER, LAURA KAY (APN)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:KAY
Last Name:COOPER
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 E LONG ST
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89706-3100
Mailing Address - Country:US
Mailing Address - Phone:775-887-2195
Mailing Address - Fax:775-887-2192
Practice Address - Street 1:900 E LONG ST
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89706-3100
Practice Address - Country:US
Practice Address - Phone:775-887-2195
Practice Address - Fax:775-887-2192
Is Sole Proprietor?:No
Enumeration Date:2012-12-03
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPRN00269363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health