Mackenzie Copenhaver
Individual provider Active NPI Community Health Worker · Rupert, WV
NPI 1053905802 · NPPES record last updated Feb 23, 2021
Key facts
- NPI
- 1053905802
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Community Health Worker 172V00000X
- Practice address
- 1032 Anjean Rd
Rupert, WV 25984-8618 - Phone
- (304) 661-0026
- NPI assigned
- Feb 23, 2021
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | Yes |
Addresses
Primary practice location
1032 Anjean Rd
Rupert, WV 25984-8618
Mailing address
1032 Anjean Rd
Rupert, WV 25984-8618
Phone (304) 661-0026
Other providers in Rupert, WV
- Barbara Ann Burdette
- James P Cash
- Heather Lynn Cochrum
- Heather Nicole Collins
- Mackenzie Cook
- Jessica Crane
- Kristen Dennison
- Lora Denny
- Christy Paige Estep
- Debra Fitzwater
All providers in Rupert, WV · Community Health Worker in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 23, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.