Individual
JESSICA COPPOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
B430 KU HOSPITAL, MAIL STOP 4022 3901 RAINBOW BLVD, KANSAS CITY, KS 66160-0001
(913) 588-6673
Mailing address
11033 WOODSON RD, OSWEGO, KS 67356-8701
(620) 778-2297
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
114199
KS
Other
Enumeration date
12/14/2016
Last updated
12/14/2016
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