Individual
STEPHANIE L COPELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
620 SKYLINE DR, JACKSON, TN 38301-3923
(523) 592-9957
Mailing address
88 WILDWOOD LN, JACKSON, TN 38301-3426
(523) 592-9957
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
11018
TN
367500000X
Certified Registered Nurse Anesthetist
814592
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3631982
—
TN
Enumeration date
09/26/2005
Last updated
08/13/2023
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