Healthcare Provider Details

I. General information

NPI: 1699247288
Provider Name (Legal Business Name): DANELLE ERIN KOPPES NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2018
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20046 WALKER RD STE 7
SHAKER HEIGHTS OH
44122-3645
US

IV. Provider business mailing address

1968 17TH RD
CLAY CENTER KS
67432-7420
US

V. Phone/Fax

Practice location:
  • Phone: 888-316-0451
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5024077
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5378338052
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number40974
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: