Individual provider · Type 1 NPI
Laurel Katherine Hallock Koppelman, FNP-C
Family Nurse Practitioner · Portland, OR
NPI number
1942623764
Active
Practice location
12720 SE Division Street
Portland, OR 97236
Mailing address
421 SW Oak St, Ste. 210
Portland, OR 97204-1817
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 201392556 (OR) |
Family Nurse Practitioner: Definition to come...
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About NPI 1942623764
Laurel Katherine Hallock Koppelman, FNP-C's National Provider Identifier is 1942623764, issued on Jan 30, 2014. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Portland, OR. The record was last updated on Apr 23, 2014.