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General NPI Number Information
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NPI Number | 1619880101
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Entity Type | Individual
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Provider Name | AMY KOPPIEN
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Gender | Female
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Dates
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Enumeration Date | 09/24/2026
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Last Update Date | 09/24/2026
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Provider Practice Location Address
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Address Line | 7628 W SPUR DR
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City | PEORIA
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State | AZ
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Zip | 85383-6212
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Country | US
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Telephone | 605-929-3546
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Fax |
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Provider Business Mailing Address
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Address Line | 7628 W SPUR DR
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City | PEORIA
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State | AZ
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Zip | 85383-6212
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Country | US
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Telephone | 605-929-3546
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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 | 207PH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Emergency Medicine) Physician
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License Number | 235314
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License Number State | AZ
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