Provider Demographics
NPI:1336487545
Name:KOPEC, MARY ANN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:MARY ANN
Middle Name:
Last Name:KOPEC
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3510
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15230-3510
Mailing Address - Country:US
Mailing Address - Phone:412-288-2130
Mailing Address - Fax:
Practice Address - Street 1:99 AUTUMN ST
Practice Address - Street 2:
Practice Address - City:ALIQUIPPA
Practice Address - State:PA
Practice Address - Zip Code:15001-1301
Practice Address - Country:US
Practice Address - Phone:724-375-8147
Practice Address - Fax:724-375-2435
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-23
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH269825363LF0000X
PASP012792363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily