Basic Information
| Provider Information | |||||||||
| NPI: | 1508167180 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COPPLE | ||||||||
| FirstName: | CHANDA | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | RN, BSN, CDE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8055 O ST | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | LINCOLN | ||||||||
| State: | NE | ||||||||
| PostalCode: | 685102564 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4024210904 | ||||||||
| FaxNumber: | 4024210946 | ||||||||
| Practice Location | |||||||||
| Address1: | 1601 N 86TH ST | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | LINCOLN | ||||||||
| State: | NE | ||||||||
| PostalCode: | 685053713 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4024843440 | ||||||||
| FaxNumber: | 4024843441 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/12/2010 | ||||||||
| LastUpdateDate: | 11/12/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WD0400X | 68701 | NE | Y | Nursing Service Providers | Registered Nurse | Diabetes Educator |
No ID Information.