Provider Demographics
NPI:1679549141
Name:COPE, DARLA KY (FNP-BC)
Entity Type:Individual
Prefix:
First Name:DARLA
Middle Name:KY
Last Name:COPE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:DARLA
Other - Middle Name:K
Other - Last Name:EVERHART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2791 N WASHINGTON ST
Mailing Address - Street 2:HEDRICK FAMILY CARE
Mailing Address - City:CHILLICOTHE
Mailing Address - State:MO
Mailing Address - Zip Code:64601-2902
Mailing Address - Country:US
Mailing Address - Phone:660-646-2682
Mailing Address - Fax:660-214-8611
Practice Address - Street 1:2791 N WASHINGTON ST
Practice Address - Street 2:HEDRICK FAMILY CARE
Practice Address - City:CHILLICOTHE
Practice Address - State:MO
Practice Address - Zip Code:64601-2902
Practice Address - Country:US
Practice Address - Phone:660-646-2682
Practice Address - Fax:660-214-8611
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-24
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO113657363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO429344708Medicaid
MO34889019OtherBCBS
MOE55D399Medicare ID - Type Unspecified
MO429344708Medicaid