Individual provider · Type 1 NPI

Cooper Boone Utley

Student in an Organized Health Care Education/Training Program · Athens, GA

NPI number 1386576478 Active

Practice location

250 W Green St
Athens, GA 30602-5036

Call (706) 542-1911 Map

Mailing address

840 Zion Hope Rd
Tifton, GA 31793-5407

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XPHI-023067 (GA)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1386576478

Cooper Boone Utley's National Provider Identifier is 1386576478, issued on Jun 2, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Athens, GA. The record was last updated on Jun 2, 2026.