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Individual

VANESSA LATIMER COPELAND

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
434 WOODBARK CT, MAULDIN, SC 29662-3269
(864) 365-5660
(864) 365-5660
Mailing address
434 WOODBARK CT, MAULDIN, SC 29662-3269
(864) 365-5660

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
21615
SC
363LF0000X
Family Nurse Practitioner
222331
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
NP5200
SC
01
SCC4375019
MEDICARE PIN
SC
Enumeration date
02/21/2018
Last updated
02/28/2019
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