Christina M Copeland, LPN

Individual provider Active NPI Licensed Practical Nurse · Fairfield, IL

NPI 1467016758 · NPPES record last updated Apr 23, 2019

Key facts

NPI
1467016758
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
043119450 (IL)
Practice address
209 NW 11TH St
Fairfield, IL 62837-1218
Phone
(618) 842-4470
NPI assigned
Apr 23, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
043119450ILMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 043119450 IL Yes

Addresses

Primary practice location

209 NW 11TH St
Fairfield, IL 62837-1218

Mailing address

4241 Highway 14 W
Christopher, IL 62822-1037

Other providers in Fairfield, IL

All providers in Fairfield, IL · Licensed Practical Nurse in Illinois

Sources for this page

Verify at the official NPI Registry.