Provider Demographics
NPI:1902870504
Name:COPLEY, ROBIN L (CRNA)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:L
Last Name:COPLEY
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1410 AUSTIN HILL RD
Mailing Address - Street 2:
Mailing Address - City:SHEFFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:16347-2430
Mailing Address - Country:US
Mailing Address - Phone:814-730-5588
Mailing Address - Fax:814-837-7992
Practice Address - Street 1:4372 ROUTE 6
Practice Address - Street 2:
Practice Address - City:KANE
Practice Address - State:PA
Practice Address - Zip Code:16735-3060
Practice Address - Country:US
Practice Address - Phone:814-837-8585
Practice Address - Fax:814-837-7992
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN281009L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARN281009LOtherLICENSE
PA020404Medicare ID - Type Unspecified