NPI | 1508155136 |
---|---|
Former Name | SUSIE K COPELAND |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3006841) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3006841) |
Enumeration Date | 2011-04-05 |
Last Update Date | 2024-04-29 |