Basic Information
Provider Information
NPI: 1154468346
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COPLING
FirstName: PATSY
MiddleName: J.
NamePrefix:  
NameSuffix:  
Credential: FNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 2580
Address2:  
City: SPRINGFIELD
State: MO
PostalCode: 658012580
CountryCode: US
TelephoneNumber: 4178294620
FaxNumber: 4178294316
Practice Location
Address1: 518 PINE ST
Address2:  
City: STEELVILLE
State: MO
PostalCode: 655656041
CountryCode: US
TelephoneNumber: 5737755838
FaxNumber: 5737755008
Other Information
ProviderEnumerationDate: 01/30/2007
LastUpdateDate: 07/09/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X103862MOY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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