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NPI Code Detail

MEDICARE: KAINE COPELAND

MEDICARE:   KAINE  COPELAND
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerRN219726GA

General Provider Information

NPI Number : 1144084385
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAINE COPELAND
Provider Business Mailing Address
First Line : 2572 CENTENNIAL CV
Second Line :
City : ATLANTA
State : GA
Zip : 30349-8633
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2572 CENTENNIAL CV
Second Line :
City : ATLANTA
State : GA
Zip : 30349-8633
Country : US
Telephone Number : 678-438-2779
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2024
Last Update Date : 02/08/2024

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Directions to “ KAINE COPELAND ” Practice Location

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