Individual
KAITLYN COPELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
405 W GRAND AVE, DAYTON, OH 45405-7538
(937) 723-3200
Mailing address
1 PRESTIGE PL STE 550, MIAMISBURG, OH 45342-6115
(937) 762-1310
(937) 522-8068
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
2020012508
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0414978
—
OH
Enumeration date
08/07/2020
Last updated
03/08/2021
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