Provider Demographics
NPI:1922242155
Name:APPLEBY-COOPER, KATHLEEN
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:APPLEBY-COOPER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 NW COMMONS LOOP
Mailing Address - Street 2:#115-312
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32055-7709
Mailing Address - Country:US
Mailing Address - Phone:407-352-1200
Mailing Address - Fax:386-752-7839
Practice Address - Street 1:295 NW COMMONS LOOP
Practice Address - Street 2:#115-312
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32055-7709
Practice Address - Country:US
Practice Address - Phone:407-352-1200
Practice Address - Fax:386-752-7839
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-01
Last Update Date:2009-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist