1033550538 NPI number — TONIA MARIE COPSEY CNP

Table of content: TONIA MARIE COPSEY CNP (NPI 1033550538)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033550538 NPI number — TONIA MARIE COPSEY CNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COPSEY
Provider First Name:
TONIA
Provider Middle Name:
MARIE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033550538
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/04/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1111 HAYES AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SANDUSKY
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44870-3323
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-557-7893
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
MAGRUDER WOUND HEALING CENTER
Provider Second Line Business Practice Location Address:
611 FULTON ST. STE. E
Provider Business Practice Location Address City Name:
PORT CLINTON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43452
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-301-4380
Provider Business Practice Location Address Fax Number:
419-732-1010
Provider Enumeration Date:
07/12/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LA2200X , with the licence number:  RN297428-COA1 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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