Individual
LATISHA COPPLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1430 OLIVE ST, SUITE 100, SAINT LOUIS, MO 63103-2303
(314) 621-5000
Mailing address
516 N AUGUST ST, APT 2A, MASCOUTAH, IL 62258-1536
(618) 708-0924
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
2013035086
MO
Other
Enumeration date
12/03/2014
Last updated
12/03/2014
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