Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 298857 | NC |
NPI | 1033636535 |
---|---|
Provider Name | Tabitha Copeland |
First Address | Creedmoor, NC 27522-8196 |
Second Address | Laurinburg, NC 28352-9170 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2017 |
Last Update Date | 24/08/2017 |