Provider Demographics
NPI:1417232604
Name:COPELAND, WENDY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:
Last Name:COPELAND
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:
Other - Last Name:KAMPPI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1901 PRAIRIE AVE
Mailing Address - Street 2:
Mailing Address - City:BELOIT
Mailing Address - State:WI
Mailing Address - Zip Code:53511-3133
Mailing Address - Country:US
Mailing Address - Phone:608-365-2001
Mailing Address - Fax:608-365-3786
Practice Address - Street 1:1901 PRAIRIE AVE
Practice Address - Street 2:
Practice Address - City:BELOIT
Practice Address - State:WI
Practice Address - Zip Code:53511-3133
Practice Address - Country:US
Practice Address - Phone:608-365-2001
Practice Address - Fax:608-365-3786
Is Sole Proprietor?:No
Enumeration Date:2011-10-19
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI361924025183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL051-303555OtherSTATE LICENSE
WI15779-40OtherSTATE LICENSE