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NPI Code Detail

MEDICARE: DONALD COPELAND AGNP-C

MEDICARE: DONALD COPELAND AGNP-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
1363LG0600XGerontology Nurse PractitionerAP8204AZ
2363LA2200XAdult Health Nurse PractitionerAP8204AZ

General Provider Information

NPI Number : 1861867301
Entity Type Code : Individual
Provider Name (Legal Business Name) : DONALD COPELAND AGNP-C
Provider Business Mailing Address
First Line : 5916 E MCKELLIPS RD
Second Line :
City : MESA
State : AZ
Zip : 85215-2755
Country : US
Telephone Number : 480-930-4477
Fax Number : 415-252-7176
Provider Business Practice Location Address
First Line : 5916 E MCKELLIPS RD
Second Line :
City : MESA
State : AZ
Zip : 85215-2755
Country : US
Telephone Number : 480-930-4477
Fax Number : 415-252-7176
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2015
Last Update Date : 04/17/2025

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Directions to “ DONALD COPELAND AGNP-C” Practice Location

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