Provider Demographics
NPI:1942052964
Name:COPLIN, DANIELLE
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:COPLIN
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 1:230 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:VERMONTVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49096-9415
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:230 N MAIN ST
Practice Address - Street 2:
Practice Address - City:VERMONTVILLE
Practice Address - State:MI
Practice Address - Zip Code:49096-9415
Practice Address - Country:US
Practice Address - Phone:269-908-9303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704384845163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse