Cooper, Krysta Mychal

Cooper, Krysta Mychal is an individual health care provider with primary practice located at 4790 Cottonville Rd , Jamestown OH 45335-1518. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Cooper, Krysta Mychal can be contacted via phone (937) 675-2870.

Contact Information

Primary practice address
4790 Cottonville Rd Jamestown OH 45335-1518
Phone: (937) 675-2870
Fax: (937) 675-2873
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X LE-00024808 Ohio
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X APRN.CNP.023461 Ohio

Profile Details

NPI number 1346728730
LBN Legal business name Cooper, Krysta Mychal
Credentials APRN, CNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 30th, 2018
Last updated Dec 2nd, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346728730 NPPES
Ohio MEDICAID 0315026

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