Provider Demographics
NPI:1598009961
Name:KOPFMAN, DAWNETTE
Entity Type:Individual
Prefix:MRS
First Name:DAWNETTE
Middle Name:
Last Name:KOPFMAN
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 1:2032 RICHERT AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-5236
Mailing Address - Country:US
Mailing Address - Phone:559-281-3180
Mailing Address - Fax:
Practice Address - Street 1:2210 E ILLINOIS AVE
Practice Address - Street 2:STE #406
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93701-2125
Practice Address - Country:US
Practice Address - Phone:559-486-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-24
Last Update Date:2012-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN431026363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology