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Individual

CHRISTINA M COPELAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
209 NW 11TH ST, FAIRFIELD, IL 62837-1218
(618) 842-4470
Mailing address
4241 HIGHWAY 14 W, CHRISTOPHER, IL 62822-1037

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043119450
IL

Other

Enumeration date
04/23/2019
Last updated
04/23/2019
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