Provider Demographics
NPI:1336340462
Name:KOPAN, KAREN L (APN-CNP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:L
Last Name:KOPAN
Suffix:
Gender:F
Credentials:APN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22666 LENOX DR
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW PARK
Mailing Address - State:OH
Mailing Address - Zip Code:44126-3600
Mailing Address - Country:US
Mailing Address - Phone:847-636-1607
Mailing Address - Fax:
Practice Address - Street 1:9500 EUCLID AVE # G30
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-1718
Practice Address - Country:US
Practice Address - Phone:847-636-1607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209-002246363LC0200X
OHAPRN.CNP.0030727364SA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2100XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAcute Care
No363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine