MEDICARE: ESTHER COPELAND FNP

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
1	363LF0000X	Family Nurse Practitioner	A187652	IA
2	363LF0000X	Family Nurse Practitioner	902793	MS
3	363LF0000X	Family Nurse Practitioner	2024031483	OH
4	363LF0000X	Family Nurse Practitioner	53-84718-071	KS
5	363LF0000X	Family Nurse Practitioner	2024031483	MO

General Provider Information

NPI Number	:	1346707338
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ESTHER COPELAND FNP

Provider Business Mailing Address
First Line	:	PO BOX 740019
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-0019
Country	:	US
Telephone Number	:	312-733-9730
Fax Number	:

Provider Business Practice Location Address
First Line	:	3863A GRAVOIS AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63116-4657
Country	:	US
Telephone Number	:	314-888-0981
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2019
Last Update Date	:	10/23/2025

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