Individual
KEVIN COPLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
927 N BUSINESS 71, ANDERSON, MO 64831
(417) 845-8300
Mailing address
8 DILLOW LN, BELLA VISTA, AR 72714-4010
(812) 801-6931
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2021014780
MO
363LF0000X
Family Nurse Practitioner
A006089
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A006089
LICENSE #
AR
Enumeration date
01/30/2019
Last updated
08/16/2021
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