Provider Demographics
NPI:1326303975
Name:COPPOLA, WHITNEY JAMES
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:JAMES
Last Name:COPPOLA
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 1:156 BURNETTS WAY
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-8166
Mailing Address - Country:US
Mailing Address - Phone:757-934-6470
Mailing Address - Fax:757-934-6471
Practice Address - Street 1:4828 HARBOR OAKS WAY
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455
Practice Address - Country:US
Practice Address - Phone:757-636-6521
Practice Address - Fax:888-417-8523
Is Sole Proprietor?:No
Enumeration Date:2012-07-10
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist