Basic Information
| Provider Information | |||||||||
| NPI: | 1003003443 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COPAS | ||||||||
| FirstName: | VIRGINIA | ||||||||
| MiddleName: | DIANE | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | RN.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2312 COLONIAL VIEW ROAD | ||||||||
| Address2: | |||||||||
| City: | KINGSPORT | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37663 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4232393614 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 904 FORDTOWN RD | ||||||||
| Address2: | |||||||||
| City: | KINGSPORT | ||||||||
| State: | TN | ||||||||
| PostalCode: | 376633208 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4233541760 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/01/2007 | ||||||||
| LastUpdateDate: | 10/01/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WS0200X | RN0000085014 | TN | Y | Nursing Service Providers | Registered Nurse | School |
No ID Information.