Individual
JENNIFER ELAINE KOPNICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17177 N LAUREL PARK DR STE 131, LIVONIA, MI 48152-3952
(734) 462-3210
Mailing address
2911 PONTIAC LAKE RD, WATERFORD, MI 48328-2681
(951) 505-5465
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704318207
MI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704318207
MI
Other
Enumeration date
01/13/2025
Last updated
09/05/2025
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