Kopp, Keely Egan
Kopp, Keely Egan is an individual health care provider with primary practice located at 2180 Main St , Wailuku HI 96793-1625. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Kopp, Keely Egan can be contacted via phone (808) 242-6464.Contact Information
Primary practice address
2180 Main St
Wailuku HI 96793-1625
Phone: (808) 242-6464
Fax: (808) 242-4292
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA001129 | Maine |
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | AMD-522 | Hawaii |
Profile Details
NPI number | 1356506190 |
---|---|
LBN Legal business name | Kopp, Keely Egan |
Credentials | Physician's Assistant Certified (PA-C) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jul 22nd, 2008 |
Last updated | Oct 22nd, 2013 - about 11 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1356506190 | NPPES |
Maine | MEDICAID | 433005199 | |
Maine | MEDICAID | 30336793 |
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