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NPI Code Detail

MEDICARE: STEPHANIE L COPELAND CRNA

MEDICARE: STEPHANIE L COPELAND CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse Anesthetist814592TX
2367500000XCertified Registered Nurse Anesthetist11018TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255327292
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE L COPELAND CRNA
Provider Business Mailing Address
First Line : 88 WILDWOOD LN
Second Line :
City : JACKSON
State : TN
Zip : 38301-3426
Country : US
Telephone Number : 523-592-9957
Fax Number :
Provider Business Practice Location Address
First Line : 620 SKYLINE DR
Second Line :
City : JACKSON
State : TN
Zip : 38301-3923
Country : US
Telephone Number : 523-592-9957
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2005
Last Update Date : 08/13/2023

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Directions to “ STEPHANIE L COPELAND CRNA” Practice Location

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