Provider Demographics
NPI:1720325103
Name:COPHER, LINDA JO (ARNP MSN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:JO
Last Name:COPHER
Suffix:
Gender:F
Credentials:ARNP MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5860 RANCH LAKE BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34202-3719
Mailing Address - Country:US
Mailing Address - Phone:941-388-8997
Mailing Address - Fax:941-306-5876
Practice Address - Street 1:5860 RANCH LAKE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34202-3719
Practice Address - Country:US
Practice Address - Phone:941-388-8997
Practice Address - Fax:941-306-5876
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-06
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9350290363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily