Provider Demographics
NPI:1457089799
Name:COPELAND, JENNIFER LYNN (BSN, RN, CCRN)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LYNN
Last Name:COPELAND
Suffix:
Gender:F
Credentials:BSN, RN, CCRN
Other - Prefix:MRS
Other - First Name:JENNIFER
Other - Middle Name:LYNN
Other - Last Name:HERRINGTON, HALFMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 126292
Mailing Address - Street 2:
Mailing Address - City:FT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76126-0292
Mailing Address - Country:US
Mailing Address - Phone:817-879-1464
Mailing Address - Fax:
Practice Address - Street 1:425 CRESTED RIDGE LN
Practice Address - Street 2:
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76108-9618
Practice Address - Country:US
Practice Address - Phone:817-879-1464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-14
Last Update Date:2022-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX816809163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse