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General NPI Number Information
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NPI Number | 1942648308
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Entity Type | Individual
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Provider Name | MICHELLE COPLIN NP
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Gender | Female
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Dates
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Enumeration Date | 06/07/2013
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Last Update Date | 04/25/2023
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Provider Practice Location Address
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Address Line | 506 4TH ST
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City | LA GRANDE
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State | OR
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Zip | 97850-1906
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Country | US
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Telephone | 541-962-1101
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Fax |
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Provider Business Mailing Address
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Address Line | 506 4TH ST
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City | LA GRANDE
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State | OR
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Zip | 97850-1906
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Country | US
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Telephone | 541-962-1101
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 10006630
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 0094000241RN
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License Number State | OR
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