Individual
KATHLEEN R KOPACZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
715 S 9TH ST, CANON CITY, CO 81212-4911
(719) 269-8820
(719) 204-0230
Mailing address
715 S 9TH ST, CANON CITY, CO 81212-4911
(719) 269-8820
(719) 204-0230
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APN.0997105-NP
CO
Other
Enumeration date
12/02/2021
Last updated
12/02/2021
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