| Crystal Ann Cooper, APRN | |
| 39 Cumberland Gap Plz, Gray, KY 40734-4536 | |
| (606) 526-9005 | |
| (606) 526-8607 | 
| Full Name | Crystal Ann Cooper | 
|---|---|
| Gender | Female | 
| Speciality | Nurse Practitioner - Family | 
| Location | 39 Cumberland Gap Plz, Gray, Kentucky | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1699029462 | NPI | - | NPPES | 
| Q007160 | Medicaid | TN | |
| 7100225480 | Medicaid | KY | |
| K068550 | Other | KY | MEDICARE PTAN | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 3007739 (Kentucky) | Secondary | 
| 363LF0000X | Nurse Practitioner - Family | 19111 (Tennessee) | Primary | 
| Entity Name | Genesis Eldercare Physician Services Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1790188076 PECOS PAC ID: 9830002534 Enrollment ID: O20150617002292 | 
| Entity Name | Alignmed Partners Pc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1881109452 PECOS PAC ID: 9739447400 Enrollment ID: O20180613000611 | 
| Entity Name | Signify Health Medical Associates Pllc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1750845863 PECOS PAC ID: 2163764424 Enrollment ID: O20191218003345 | 
| Entity Name | Alignmed Medical Group Pc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1366289423 PECOS PAC ID: 3476090440 Enrollment ID: O20240808001303 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Crystal Ann Cooper, APRN Po Box 1325, Corbin, KY 40702-1325 Ph: (606) 526-8131 | Crystal Ann Cooper, APRN 39 Cumberland Gap Plz, Gray, KY 40734-4536 Ph: (606) 526-9005 | 
| Ms. Tammy L Freeman, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 10755 N Us Highway 25e, Gray, KY 40734 Phone: 606-258-8050 Fax: 606-258-8994 | |
| Natasha Garrison, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3191 Ky 1232, Gray, KY 40734 Phone: 606-260-2246 | |
| Mrs. Edna Eugenia Stewart, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 39 Cumberland Gap Plaza, Gray, KY 40734 Phone: 606-526-9005 Fax: 606-526-8606 | |
| Mr. Vernon Eugene Taylor Jr., APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 39 Cumberland Gap Plz, Gray, KY 40734 Phone: 606-526-9005 Fax: 606-526-8607 | |
| Mrs. Mary Beth Lopez, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 39 Cumberland Gap Plz, Gray, KY 40734 Phone: 606-526-9005 Fax: 606-526-8607 | |
| Mrs. Rita Carol Gilbert, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 39 Cumberland Gap Plz, Gray, KY 40734 Phone: 606-275-3415 | |
| Loretta Sue Wilson, N.P Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 39 Cumberland Gap Plz, Gray, KY 40734 Phone: 606-526-9005 Fax: 606-526-8606 |