Provider Demographics
NPI:1497025175
Name:KOPP, ABBIGAIL L (PHARMD)
Entity Type:Individual
Prefix:
First Name:ABBIGAIL
Middle Name:L
Last Name:KOPP
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 SAM PERRY BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-8420
Mailing Address - Country:US
Mailing Address - Phone:540-741-1061
Mailing Address - Fax:
Practice Address - Street 1:1301 SAM PERRY BLVD STE 100
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-8420
Practice Address - Country:US
Practice Address - Phone:540-741-1061
Practice Address - Fax:540-741-1810
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-11
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202209284183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist