Provider Demographics
NPI:1033233804
Name:KOPANS, NANCEE IDA
Entity Type:Individual
Prefix:MS
First Name:NANCEE
Middle Name:IDA
Last Name:KOPANS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2337 PEMBURY DR
Mailing Address - Street 2:
Mailing Address - City:XENIA
Mailing Address - State:OH
Mailing Address - Zip Code:45385-4723
Mailing Address - Country:US
Mailing Address - Phone:937-372-4928
Mailing Address - Fax:
Practice Address - Street 1:2023 PENBROOKE TRL
Practice Address - Street 2:
Practice Address - City:CENTERVILLE FINANCE
Practice Address - State:OH
Practice Address - Zip Code:45459-3433
Practice Address - Country:US
Practice Address - Phone:937-432-2167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2522176OtherPROVIDER NUMBER