Provider Demographics
NPI:1952831489
Name:COPPER, VANESSA L (NP)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:L
Last Name:COPPER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:VANESSA
Other - Middle Name:
Other - Last Name:FOSTER AND MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:101 E ALEX BELL RD STE 190
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45459-2752
Mailing Address - Country:US
Mailing Address - Phone:937-425-4030
Mailing Address - Fax:937-425-4039
Practice Address - Street 1:62 WHISPER WAY
Practice Address - Street 2:
Practice Address - City:EATON
Practice Address - State:OH
Practice Address - Zip Code:45320-9597
Practice Address - Country:US
Practice Address - Phone:937-608-7413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-18
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71007237A363LF0000X
OHAPRNCNP020597363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily