Provider Demographics
NPI:1518095033
Name:COPELAND, CARRIE A (CNM-MSN)
Entity Type:Individual
Prefix:MS
First Name:CARRIE
Middle Name:A
Last Name:COPELAND
Suffix:
Gender:F
Credentials:CNM-MSN
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 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-316-5270
Mailing Address - Fax:704-316-5271
Practice Address - Street 1:1718 EAST 4TH STREET
Practice Address - Street 2:SUITE 707
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-3282
Practice Address - Country:US
Practice Address - Phone:704-316-5270
Practice Address - Fax:704-316-5271
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11021494367A00000X
NC318367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7002061Medicaid
NC2592534BOtherCIGNA MEDICARE