Individual
KELLY COPELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2825 N KANSAS EXPY, SPRINGFIELD, MO 65803
(417) 868-7026
(417) 868-7033
Mailing address
PO BOX 4046, SPRINGFIELD, MO 65808-4046
(417) 269-5712
(417) 269-7567
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2014044258
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457741621
—
MO
01
—
2014044258
NP LICENSE
MO
Enumeration date
01/27/2015
Last updated
08/01/2018
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