Individual
MRS. KATHRYN MARIE COPAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
1121 S INDIANA AVE, CROWN POINT, IN 46307-8516
(219) 663-5413
(219) 663-5491
Mailing address
1121 S INDIANA AVE, CROWN POINT, IN 46307-8516
(219) 663-5413
(219) 663-5491
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
28116773A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200449790
—
IN
Enumeration date
03/12/2008
Last updated
03/12/2008
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