Provider Demographics
NPI:1720605991
Name:COPELAND, GIOVANNI LAGRETTA
Entity Type:Individual
Prefix:MISS
First Name:GIOVANNI
Middle Name:LAGRETTA
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 1:6501 14TH ST NW APT 406
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20012-2939
Mailing Address - Country:US
Mailing Address - Phone:202-867-2229
Mailing Address - Fax:
Practice Address - Street 1:6501 14TH ST NW APT 406
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-2939
Practice Address - Country:US
Practice Address - Phone:202-867-2229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-02
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant