Healthcare Provider Details

I. General information

NPI: 1811654361
Provider Name (Legal Business Name): SHERRY COPLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2021
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 PATRICK STREET PLZ
CHARLESTON WV
25387-2444
US

IV. Provider business mailing address

7110 MOCKINGBIRD TRL
CATLETTSBURG KY
41129-8154
US

V. Phone/Fax

Practice location:
  • Phone: 304-233-3200
  • Fax:
Mailing address:
  • Phone: 606-547-7958
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number124243
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number4046490
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number124243
License Number StateWV
# 4
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number1174358
License Number StateKY
# 5
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number124243
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: