Individual
KATIE ANN COPPOLA
Active
Individual
KATIE ANN COPPOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
003473
CT
363AM0700X
Medical Physician Assistant
Primary
003473
CT
363AS0400X
Surgical Physician Assistant
003473
CT
363AS0400X
Surgical Physician Assistant
25MP00328600
NJ
Other
Enumeration date
05/07/2014
Last updated
01/11/2016
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