Provider Demographics
NPI:1336981414
Name:COPPOCK, LINDSAY DAWN (RN)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:DAWN
Last Name:COPPOCK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:987 E ASH ST STE A2
Mailing Address - Street 2:
Mailing Address - City:PIQUA
Mailing Address - State:OH
Mailing Address - Zip Code:45356-4133
Mailing Address - Country:US
Mailing Address - Phone:937-214-6887
Mailing Address - Fax:
Practice Address - Street 1:987 E ASH ST
Practice Address - Street 2:
Practice Address - City:PIQUA
Practice Address - State:OH
Practice Address - Zip Code:45356-4133
Practice Address - Country:US
Practice Address - Phone:937-615-6015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
OHRN.437978163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No171M00000XOther Service ProvidersCase Manager/Care Coordinator