Provider Demographics
NPI:1952873580
Name:COPELAND, MSITY LYNN (RN)
Entity Type:Individual
Prefix:
First Name:MSITY
Middle Name:LYNN
Last Name:COPELAND
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 PALUXY DR APT 2132
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-2166
Mailing Address - Country:US
Mailing Address - Phone:903-806-2513
Mailing Address - Fax:
Practice Address - Street 1:4400 PALUXY DR APT 2132
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-2166
Practice Address - Country:US
Practice Address - Phone:903-806-2513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-20
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX813338163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse