Provider Demographics
NPI:1679545719
Name:COPELAND, DEBORAH JEAN (RN, BSN, CGRN)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:JEAN
Last Name:COPELAND
Suffix:
Gender:F
Credentials:RN, BSN, CGRN
Other - Prefix:MRS
Other - First Name:DEBORAH
Other - Middle Name:JEAN
Other - Last Name:WALZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, BSN, CGRN
Mailing Address - Street 1:4615 E PEARCE RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-1126
Mailing Address - Country:US
Mailing Address - Phone:480-598-9945
Mailing Address - Fax:
Practice Address - Street 1:1400 S DOBSON RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-4707
Practice Address - Country:US
Practice Address - Phone:480-512-3800
Practice Address - Fax:480-512-8756
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN043736163WG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0100XNursing Service ProvidersRegistered NurseGastroenterology