Healthcare Provider Details

I. General information

NPI: 1881804375
Provider Name (Legal Business Name): CHRISTINE MARY COPPINGER RNC, NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1365 CLIFTON RD NE
ATLANTA GA
30322-1013
US

IV. Provider business mailing address

365 GLEN COVE DR
AVONDALE ESTATES GA
30002-1162
US

V. Phone/Fax

Practice location:
  • Phone: 404-778-4523
  • Fax:
Mailing address:
  • Phone: 404-296-6273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberRN110853 NP
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: