Individual
JEANNE L. KOPACKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2000 HOWARD FARM DR STE 200, CUMMING, GA 30041-6081
(770) 292-6500
(770) 292-6535
Mailing address
5671 PEACHTREE DUNWOODY RD NE, SUITE 700, ATLANTA, GA 30342-5000
(404) 847-9999
(404) 531-8466
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002005
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806351077A
—
GA
05
—
806351077B
—
GA
Enumeration date
02/22/2006
Last updated
08/29/2019
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