Provider Demographics
NPI:1255498614
Name:COPE, ROBIN M (PA-C)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:M
Last Name:COPE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 69
Mailing Address - Street 2:
Mailing Address - City:KLAWOCK
Mailing Address - State:AK
Mailing Address - Zip Code:99925-0069
Mailing Address - Country:US
Mailing Address - Phone:907-755-4800
Mailing Address - Fax:907-755-4981
Practice Address - Street 1:13004 KLAWOCK HOLLIS HIGHWAY
Practice Address - Street 2:
Practice Address - City:KLAWOCK
Practice Address - State:AK
Practice Address - Zip Code:99925
Practice Address - Country:US
Practice Address - Phone:907-755-4800
Practice Address - Fax:907-755-4981
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK736363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK8EE140Medicare PIN