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NPI Code Detail

MEDICARE: TAMMY ELLEN COPELAND RN

MEDICARE: TAMMY ELLEN COPELAND RN
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
1163WH0200XHome Health Registered Nurse66370WV

General Provider Information

NPI Number : 1912629288
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAMMY ELLEN COPELAND RN
Provider Business Mailing Address
First Line : 32 BETH HAVEN RD
Second Line :
City : CHAUNCEY
State : WV
Zip : 25612-9504
Country : US
Telephone Number : 304-688-3572
Fax Number :
Provider Business Practice Location Address
First Line : 298 TRICORN RD
Second Line :
City : DANVILLE
State : WV
Zip : 25053-7148
Country : US
Telephone Number : 304-369-1385
Fax Number : 304-369-9684
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2022
Last Update Date : 09/14/2022

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