# MARCIA KOPACZ

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1366512634
- **Gender:** F
- **Credential:** BSN,MSN,CNP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WG0000X | General Practice Registered Nurse | 4704088147 | MI | — |
| 363L00000X | Nurse Practitioner | 4704088147 | MI | Yes |

## Other

- **Enumeration date:** 11/08/2006
- **Last updated:** 02/20/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 5008605430 | BCBS PROVIDER ID | MI |