Provider Demographics
NPI:1699104042
Name:COPELIN, NATASHA L (DNP)
Entity type:Individual
Prefix:DR
First Name:NATASHA
Middle Name:L
Last Name:COPELIN
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 MOHAWK DR
Mailing Address - Street 2:
Mailing Address - City:NORTH BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11703-3303
Mailing Address - Country:US
Mailing Address - Phone:631-486-8566
Mailing Address - Fax:631-607-8933
Practice Address - Street 1:13 MOHAWK DR
Practice Address - Street 2:
Practice Address - City:NORTH BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11703-3303
Practice Address - Country:US
Practice Address - Phone:631-486-8566
Practice Address - Fax:631-607-8933
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-06
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY308729363LA2200X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health