Individual
MS. CHANDA LATREASE COPELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
1500 GALEN ST SE, WASHINGTON, DC 20020-4936
(202) 610-7160
(202) 610-7164
Mailing address
1220 12TH ST SE, SUITE 120, WASHINGTON, DC 20003-3722
(202) 715-7900
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
R136290
MD
363LF0000X
Family Nurse Practitioner
Primary
RN65807
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024905300
—
DC
Enumeration date
11/30/2011
Last updated
06/28/2012
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