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General NPI Number Information
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NPI Number | 1669864328
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Entity Type | Individual
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Provider Name | ELLEN COOPERMAN
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Gender | Female
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Dates
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Enumeration Date | 03/04/2015
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Last Update Date | 03/04/2015
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Provider Practice Location Address
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Address Line | 427 MAIN ST
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City | HELLERTOWN
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State | PA
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Zip | 18055-1721
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Country | US
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Telephone | 610-814-7300
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Fax | 484-241-4490
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Provider Business Mailing Address
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Address Line | 427 MAIN ST
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City | HELLERTOWN
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State | PA
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Zip | 18055-1721
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Country | US
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Telephone | 610-814-7300
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Fax | 484-241-4490
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | PN274569
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License Number State | PA
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