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General NPI Number Information
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NPI Number | 1669637831
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Entity Type | Individual
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Provider Name | CAROL LYNN COPELIN RN FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/27/2008
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Last Update Date | 05/24/2021
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Provider Practice Location Address
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Address Line | 2802 W WALKER ST
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City | BRECKENRIDGE
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State | TX
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Zip | 76424
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Country | US
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Telephone | 254-559-7215
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Fax | 325-893-4035
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Provider Business Mailing Address
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Address Line | 725 PATE ST
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City | ALBANY
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State | TX
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Zip | 76430-3225
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Country | US
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Telephone | 257-622-4473
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Fax | 325-893-4035
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP117604
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License Number State | TX
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