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Individual

TAMMY M COPELAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1400 BRADEN ST, JACKSONVILLE, AR 72076-3721
(501) 985-7000
Mailing address
925 SHERWOOD DR, LAKE BLUFF, IL 60044-2203

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R27750
AR
367500000X
Certified Registered Nurse Anesthetist
Primary
C00862
AR

Other

Enumeration date
04/18/2007
Last updated
10/18/2007
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