Provider Demographics
NPI:1194130336
Name:COPLEY, VALLIE JO (APRN)
Entity type:Individual
Prefix:
First Name:VALLIE
Middle Name:JO
Last Name:COPLEY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:VALLIE
Other - Middle Name:JO
Other - Last Name:CLARY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:6613 N MERIDIAN AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73116-1423
Mailing Address - Country:US
Mailing Address - Phone:405-603-8450
Mailing Address - Fax:405-603-8455
Practice Address - Street 1:6613 N MERIDIAN AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-1423
Practice Address - Country:US
Practice Address - Phone:405-603-8450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-26
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0079679364SA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2100XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAcute Care