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Individual
MARCIA KOPACZ
Active
Individual
MARCIA KOPACZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN,MSN,CNP
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
4704088147
MI
363L00000X
Nurse Practitioner
Primary
4704088147
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5008605430
BCBS PROVIDER ID
MI
Enumeration date
11/08/2006
Last updated
02/20/2020
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