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Individual
MS. WANDA S COPELAND
Active
Individual
MS. WANDA S COPELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
669
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0207PA
—
SC
01
—
P00803328
RAILROAD MEDICARE ID-RSFPN
SC
Enumeration date
05/10/2006
Last updated
04/13/2010
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