Misty Copen, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP130002 Issued in TX

Practice address

615 Russell Blvd
Nacogdoches, TX 75965-1247

Phone

(936) 564-1740

Fax

(936) 560-4989

NPI assigned

Feb 1, 2016

Last updated

Feb 1, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1454284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454284800000",
    "number": "1528426939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6649 FM 1878",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "75961",
            "telephone_number": "318-773-9024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 RUSSELL BLVD",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759651247",
            "telephone_number": "936-564-1740",
            "fax_number": "936-560-4989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPEN",
        "first_name": "MISTY",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-01",
        "last_updated": "2016-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP130002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamala Lynn Cook, CNM
• Angela Christine Cooper, LPC
• Chelsea Elaine Cooper, FNP-C
• Haskell Cooper, PHD, LCSW
• John Darren Copen, CRNA
• Cordova Counseling Services PLLC
• Amanda Cordova, LPC- S
• Caroline Chance Corley, NP
• Cox Christian Counseling PLLC
• Brooke Elaine Cox

• Family Nurse Practitioner in Nacogdoches, TX
• Providers in Nacogdoches, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.