Provider Demographics
NPI:1003003443
Name:COPAS, VIRGINIA DIANE (RNC)
Entity Type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:DIANE
Last Name:COPAS
Suffix:
Gender:F
Credentials:RNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2312 COLONIAL VIEW ROAD
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37663
Mailing Address - Country:US
Mailing Address - Phone:423-239-3614
Mailing Address - Fax:
Practice Address - Street 1:904 FORDTOWN RD
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37663-3208
Practice Address - Country:US
Practice Address - Phone:423-354-1760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000085014163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool