Basic Information
| Provider Information | |||||||||
| NPI: | 1588265417 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HARDIN | ||||||||
| FirstName: | COOPER | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4230 HARDING PIKE STE 435 | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372054900 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153853704 | ||||||||
| FaxNumber: | 6152921321 | ||||||||
| Practice Location | |||||||||
| Address1: | 4230 HARDING PIKE STE 435 | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372054900 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153853704 | ||||||||
| FaxNumber: | 6152921321 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/06/2020 | ||||||||
| LastUpdateDate: | 01/18/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/18/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 198212 | TN | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 367500000X | 28815 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.