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General NPI Number Information
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NPI Number | 1710840889
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Entity Type | Individual
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Provider Name | BROOKESANNE PAULINE COPHER
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Gender | Female
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Dates
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Enumeration Date | 12/05/2025
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 731 E MAIN ST
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City | JACKSON
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State | OH
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Zip | 45640-2100
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Country | US
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Telephone | 740-577-3527
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Fax |
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Provider Business Mailing Address
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Address Line | 1314 US HIGHWAY 50 W
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City | BAINBRIDGE
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State | OH
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Zip | 45612-9575
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Country | US
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Telephone |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN.507896
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License Number State | OH
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