Provider Demographics
NPI:1972655462
Name:COPELAND, ELIZABETH HUGHES (CFNP)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:HUGHES
Last Name:COPELAND
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:MRS
Other - First Name:BETSY
Other - Middle Name:HUGHES
Other - Last Name:COPELAND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CFNP
Mailing Address - Street 1:130 DESIARD ST
Mailing Address - Street 2:SUITE 355
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-7319
Mailing Address - Country:US
Mailing Address - Phone:318-807-7875
Mailing Address - Fax:318-812-6603
Practice Address - Street 1:920 OLIVER RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-5702
Practice Address - Country:US
Practice Address - Phone:318-807-6267
Practice Address - Fax:318-812-6458
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP06409363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00125082Medicaid
LA2166387Medicaid
MSP46510Medicare UPIN
LA2166387Medicaid