Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LC1500X | Nurse Practitioner - Community Health | P99471 | OH |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | COA.07555 | OH |
NPI | 1285804856 |
---|---|
Provider Name | Mary E Coplin |
First Address | Cincinnati, OH 45263-0001 |
Second Address | Delphos, OH 45833-9180 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2008 |
Last Update Date | 30/06/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2440513 | (05) | OH |