Healthcare Provider Details

I. General information

NPI: 1427265297
Provider Name (Legal Business Name): MARY ANN COPSON CN, MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

154 EVENING STAR LN
SHIPMAN VA
22971-2549
US

IV. Provider business mailing address

154 EVENING STAR LN
SHIPMAN VA
22971-2549
US

V. Phone/Fax

Practice location:
  • Phone: 434-263-4996
  • Fax: 202-315-5857
Mailing address:
  • Phone: 434-263-4996
  • Fax: 202-315-5857

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: