Provider Demographics
NPI:1114530771
Name:COPLIN, MELINDA (APRN)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:
Last Name:COPLIN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 ROAD RUNNER ST
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59602-0543
Mailing Address - Country:US
Mailing Address - Phone:406-461-0889
Mailing Address - Fax:
Practice Address - Street 1:1050 ROAD RUNNER ST
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59602-0543
Practice Address - Country:US
Practice Address - Phone:406-461-0889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-24
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-APRN-LIC-161107363LF0000X
MTNUR-RN-LIC-30267163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care