Healthcare Provider Details

I. General information

NPI: 1356413595
Provider Name (Legal Business Name): CARLA DENISE COPAS ARNP, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 11/02/2022
Certification Date: 11/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3122 BLACKISTON MILL RD SUITE B
NEW ALBANY IN
47150
US

IV. Provider business mailing address

3008 ENGLE ROAD
BORDEN IN
47106
US

V. Phone/Fax

Practice location:
  • Phone: 812-725-1825
  • Fax: 812-944-1068
Mailing address:
  • Phone: 812-945-5233
  • Fax: 812-945-2804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number71004213A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number09000224A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: