Provider Demographics
NPI:1619399292
Name:COPELAND, ALANA DANIELLE
Entity Type:Individual
Prefix:
First Name:ALANA
Middle Name:DANIELLE
Last Name:COPELAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALANA
Other - Middle Name:DANIELLE
Other - Last Name:DETURK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:212 W EVERGREEN ST
Mailing Address - Street 2:
Mailing Address - City:DURANT
Mailing Address - State:OK
Mailing Address - Zip Code:74701-4710
Mailing Address - Country:US
Mailing Address - Phone:580-931-9901
Mailing Address - Fax:580-931-9953
Practice Address - Street 1:212 W EVERGREEN ST
Practice Address - Street 2:
Practice Address - City:DURANT
Practice Address - State:OK
Practice Address - Zip Code:74701-4710
Practice Address - Country:US
Practice Address - Phone:580-931-9901
Practice Address - Fax:580-931-9953
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-15
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK302827171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator