Individual
SHANNON LYNN KOPECKY
Active
Individual
SHANNON LYNN KOPECKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
041-318243
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
4998
NC
367500000X
Certified Registered Nurse Anesthetist
75953
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041-318243
IL STATE LIC
IL
Enumeration date
03/15/2007
Last updated
01/11/2024
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