Provider Demographics
NPI:1942622410
Name:COUPARD, ELANA
Entity Type:Individual
Prefix:
First Name:ELANA
Middle Name:
Last Name:COUPARD
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 1:3906 MAURICE COURT
Mailing Address - Street 2:
Mailing Address - City:MONROVIA
Mailing Address - State:MD
Mailing Address - Zip Code:21770
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3906 MAURICE CT
Practice Address - Street 2:
Practice Address - City:MONROVIA
Practice Address - State:MD
Practice Address - Zip Code:21770-9118
Practice Address - Country:US
Practice Address - Phone:301-471-1442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-17
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00116458376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide