Krysta Mychal Cooper, APRN, CNP
Individual provider Active NPI Family Nurse Practitioner · Jamestown, OH
NPI 1346728730 · NPPES record last updated Dec 2, 2020
Key facts
- NPI
- 1346728730
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- APRN.CNP.023461 (OH)
- Practice address
- 4790 Cottonville Rd
Jamestown, OH 45335-1518 - Phone
- (937) 675-2870
- Fax
- (937) 675-2873
- NPI assigned
- Jul 30, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LE-00024808 | OH | MD | Family Medicine Physician |
| APRN.CNP.023461 | OH | MD | Family Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | LE-00024808 | OH | |
| Family Nurse Practitioner | 363LF0000X | APRN.CNP.023461 | OH | Yes |
Addresses
Primary practice location
4790 Cottonville Rd
Jamestown, OH 45335-1518
Mailing address
4790 Cottonville Rd
Jamestown, OH 45335-1518
Phone (937) 675-2870
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0315026 | Medicaid | OH |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kcooper595149@direct.ketteringhealth.org | ||
| FHIR URL | https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/ |
Other providers in Jamestown, OH
- Danielle Brooks
- Chelsea Brunsman
- David P Buck
- Ana Clark
- Compunet Clinical Laboratories LLC
- CT Ohio Jamestown LLC
- Digestive Specialists, Inc.
- Robin Douglas
- Far Oaks Orthopedists, Inc
- Brionna Fifer
All providers in Jamestown, OH · Family Nurse Practitioner in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 2, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.