Provider Demographics
NPI:1275857724
Name:COPELAND, SONYA MICHELLE (LPN)
Entity Type:Individual
Prefix:MISS
First Name:SONYA
Middle Name:MICHELLE
Last Name:COPELAND
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 PROGRESS DR
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN
Mailing Address - State:CO
Mailing Address - Zip Code:80817-4177
Mailing Address - Country:US
Mailing Address - Phone:719-310-1978
Mailing Address - Fax:
Practice Address - Street 1:750 PROGRESS DR
Practice Address - Street 2:
Practice Address - City:FOUNTAIN
Practice Address - State:CO
Practice Address - Zip Code:80817-4177
Practice Address - Country:US
Practice Address - Phone:719-310-1978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-25
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO37947164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse