Individual
MRS. CHEYENNA LYNNE KOPACZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP FNP-C
Contact information
Practice address
#1098 2501 W HAPPY VALLEY RD, SUITE 4, PHOENIX, AZ 85085
(602) 489-4958
Mailing address
#1098 2501 W HAPPY VALLEY RD, SUITE 4, PHOENIX, AZ 85085
(602) 489-4958
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
227570
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
533013
—
AZ
01
—
Z229839
MEDICARE
AZ
Enumeration date
06/14/2019
Last updated
09/21/2023
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