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General NPI Number Information
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NPI Number | 1265890644
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Entity Type | Individual
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Provider Name | ANGELA KOPER CST, BHA
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Gender | Female
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Dates
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Enumeration Date | 02/01/2016
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Last Update Date | 04/16/2016
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Provider Practice Location Address
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Address Line | 4429 RABIDUE RD
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City | CLYDE
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State | MI
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Zip | 48049-2926
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Country | US
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Telephone | 810-334-4481
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Fax |
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Provider Business Mailing Address
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Address Line | 4429 RABIDUE RD
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City | CLYDE
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State | MI
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Zip | 48049-2926
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Country | US
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Telephone | 810-334-4481
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 246ZS0410X
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Taxonomy Name | Surgical Technologist
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License Number | 93807
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License Number State |
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Taxonomy #3
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Taxonomy Code | 246ZX2200X
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Taxonomy Name | Orthopedic Assistant
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License Number | 93807
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | E7830A
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License Number State | MI
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