Individual
JEAN COPPERNOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PCPRC
Contact information
Practice address
226 MARTIN ST, TWIN FALLS, ID 83301-4542
(208) 543-7230
Mailing address
18600 SE MCLOUGHLIN BLVD, MILWAUKIE, OR 97267-6723
(503) 946-3267
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
13189
ID
Other
Enumeration date
10/21/2025
Last updated
10/21/2025
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