Coppenger, Jerin C

Coppenger, Jerin C is an individual health care provider with primary practice located at 2450 Riverside Ave , Minneapolis MN 55454. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Coppenger, Jerin C can be contacted via phone (612) 672-6000.

Contact Information

Primary practice address
2450 Riverside Ave Minneapolis MN 55454
Phone: (612) 672-6000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X R 122892-0 Minnesota

Profile Details

NPI number 1578537387
LBN Legal business name Coppenger, Jerin C
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 16th, 2006
Last updated Jun 13th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578537387 NPPES
Minnesota MEDICAID 556518900

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