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Individual

MARY G KOPERSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
7910 CASS ST, OMAHA, NE 68114-3582
(402) 991-0181
(402) 964-2459
Mailing address
PO BOX 642117, OMAHA, NE 68164-8117
(402) 717-4377
(402) 717-4317

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
110902
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
110902
NE LIC
NE
Enumeration date
01/25/2008
Last updated
01/25/2008
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