Individual
MRS. DEBORAH ANN KOOPMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, FNP
Contact information
Practice address
775 TAYLOR STREET, SUTHERLIN, OR 97479
(541) 492-2087
Mailing address
775 TAYLOR STREET, SUTHERLIN, OR 97479
(541) 492-2087
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
202003290NPPP
OR
363LF0000X
Family Nurse Practitioner
Primary
202003290NP-PP
OR
363LF0000X
Family Nurse Practitioner
CP001604
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
OR
Enumeration date
07/12/2019
Last updated
03/07/2024
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