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1265160881
LISA KOOP
FORT WAYNE, IN
NPI
1265160881
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: IN 28193681A)
Enumeration Date
2022-08-11
Last Update Date
2022-08-11
Business Address
LISA KOOP
5050 N CLINTON ST
FORT WAYNE, IN 46825-5886
Phone number: 260-484-8551
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Mailing Address
LISA KOOP
5052 N CLINTON ST
FORT WAYNE, IN 46825-5822
Phone number:
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