Provider Demographics
NPI:1902339450
Name:COPELAND, MORGAN MACKENZIE
Entity Type:Individual
Prefix:MISS
First Name:MORGAN
Middle Name:MACKENZIE
Last Name:COPELAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1355 ANGUS RD
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:OK
Mailing Address - Zip Code:73463-7022
Mailing Address - Country:US
Mailing Address - Phone:580-504-9637
Mailing Address - Fax:
Practice Address - Street 1:1355 ANGUS RD
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:OK
Practice Address - Zip Code:73463-7022
Practice Address - Country:US
Practice Address - Phone:580-504-9637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-11
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator