Individual
MICHELLE NICOLE KOPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3300 GALLOWS RD, FALLS CHURCH, VA 22042-3307
(703) 776-4001
(703) 776-7113
Mailing address
PO BOX 37174, BALTIMORE, MD 21297-3174
(571) 423-5699
(571) 423-5698
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110007623
VA
363A00000X
Physician Assistant
PA6009
MA
363A00000X
Physician Assistant
—
PA
Other
Enumeration date
08/19/2015
Last updated
06/10/2021
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