| Doctor Name: | AMY L. COOPERSMITH |
| NPI Number: | 1083606503 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 9242220 |
| Business Practice Address: | 301 Dr Carter Blvd Bunnell, FL - 321106212 |
| Business Phone Number: | 3864377350 |
| Business Fax Number: | |
| Mailing Address: | 51 Renworth Ln, PALM COAST |
| State: | FL |
| Postal Code: | 321646627 |
| Phone Number: | 3865865314 |
| Fax Number: | |
| NPI Enumeration Date: | 08/19/2005 |
| NPI Last Update Date: | 12/12/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 9242220 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |