Provider Demographics
NPI:1265260954
Name:KOPERA, JOSEPH DAVID (DNP, ARNP)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:DAVID
Last Name:KOPERA
Suffix:
Gender:M
Credentials:DNP, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1236 E RUSHOLME ST STE 300
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52803-2484
Mailing Address - Country:US
Mailing Address - Phone:800-382-0707
Mailing Address - Fax:
Practice Address - Street 1:1236 E RUSHOLME ST STE 300
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52803-2484
Practice Address - Country:US
Practice Address - Phone:800-382-0707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-24
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAH180543363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care