Provider Demographics
NPI:1700553864
Name:LANNERT, COOPER
Entity type:Individual
Prefix:
First Name:COOPER
Middle Name:
Last Name:LANNERT
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 1:9040 HILLVIEW DR
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47720-7876
Mailing Address - Country:US
Mailing Address - Phone:812-550-3265
Mailing Address - Fax:
Practice Address - Street 1:9040 HILLVIEW DR
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47720-7876
Practice Address - Country:US
Practice Address - Phone:812-550-3265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-26
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist