LISA KOOP

FORT WAYNE, IN
NPI1265160881
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: IN  28193681A)
Enumeration Date2022-08-11
Last Update Date2022-08-11
Business Address
LISA KOOP
5050 N CLINTON ST
FORT WAYNE, IN 46825-5886
Phone number: 260-484-8551
Mailing Address
LISA KOOP
5052 N CLINTON ST
FORT WAYNE, IN 46825-5822
Phone number:
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