Individual
CHANEL L COPELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
ERWIN RD, DURHAM, NC 27710-0001
(919) 684-8111
Mailing address
3710 SHIPYARD BLVD, WILMINGTON, NC 28403-6147
(910) 452-1400
(910) 332-1072
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
102961
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
970016747
RAILROAD MEDICARE
NC
Enumeration date
07/20/2005
Last updated
03/16/2009
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