Healthcare Provider Details

I. General information

NPI: 1598009961
Provider Name (Legal Business Name): MRS. DAWNETTE KOPFMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/24/2012
Last Update Date: 11/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2210 E ILLINOIS AVE STE #406
FRESNO CA
93701-2125
US

IV. Provider business mailing address

2032 RICHERT AVE
CLOVIS CA
93611-5236
US

V. Phone/Fax

Practice location:
  • Phone: 559-486-8888
  • Fax:
Mailing address:
  • Phone: 559-281-3180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberRN431026
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: