MEDICARE: JENNIFER COPPER FNP-C

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	APRN-NP191912	GA

General Provider Information

NPI Number	:	1669882742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER COPPER FNP-C

Provider Business Mailing Address
First Line	:	PO BOX 658
Second Line	:
City	:	GAINESVILLE
State	:	GA
Zip	:	30503-0658
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1270 FRIENDSHIP RD.
Second Line	:
City	:	BRASELTON
State	:	GA
Zip	:	30517-5608
Country	:	US
Telephone Number	:	678-207-4050
Fax Number	:	678-207-4051

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

Provider Enumeration Date	:	04/29/2014
Last Update Date	:	10/30/2025

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