Provider Demographics
NPI:1558129239
Name:COPELAND, MYLANIE (MAY) DAWN
Entity Type:Individual
Prefix:
First Name:MYLANIE (MAY)
Middle Name:DAWN
Last Name:COPELAND
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 1:4609 PARKER AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95820-4012
Mailing Address - Country:US
Mailing Address - Phone:916-271-1776
Mailing Address - Fax:
Practice Address - Street 1:4609 PARKER AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820-4012
Practice Address - Country:US
Practice Address - Phone:916-271-1776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula