Individual
KASSI LAITEN COPELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
3120 N OAK STREET EXT STE B, VALDOSTA, GA 31602-5910
(229) 671-6170
Mailing address
3120 N OAK STREET EXT STE C, VALDOSTA, GA 31602-5910
(229) 671-6170
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN303897
GA
Other
Enumeration date
08/05/2025
Last updated
08/07/2025
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