Provider Demographics
NPI:1891167367
Name:KOPPES, SANDRA KAY (ARNP)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:KAY
Last Name:KOPPES
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:KAY
Other - Last Name:OSTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:201 S CLINTON ST STE 168
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-4034
Mailing Address - Country:US
Mailing Address - Phone:319-384-8877
Mailing Address - Fax:319-384-0603
Practice Address - Street 1:201 S CLINTON ST STE 168
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240
Practice Address - Country:US
Practice Address - Phone:319-384-8877
Practice Address - Fax:319-384-0603
Is Sole Proprietor?:No
Enumeration Date:2015-10-23
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA128221363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily