Individual
MS. MICHELLE L. KOPF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C-FNP
Contact information
Practice address
830 PENNSYLVANIA AVE, SUITE 103, CHARLESTON, WV 25302-3302
(304) 388-2925
(304) 388-1577
Mailing address
12 ROLLER RD, CHARLESTON, WV 25314-1278
(304) 343-3681
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
51654
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NP13373
CMS PROVIDER ID
WV
Enumeration date
08/21/2006
Last updated
07/08/2007
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