Basic Information
Provider Information
NPI: 1215333950
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COPE
FirstName: DONALD
MiddleName: AUSTIN
NamePrefix:  
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 515 CLANTON RD
Address2:  
City: CHARLOTTE
State: NC
PostalCode: 282171309
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 117 W MEDICAL CT
Address2:  
City: MARION
State: NC
PostalCode: 287525590
CountryCode: US
TelephoneNumber: 8286593966
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/07/2014
LastUpdateDate: 11/07/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X269916NCY Nursing Service ProvidersRegistered Nurse 

No ID Information.


Home