Doctor Name: | TONYA I KOOPMAN |
NPI Number: | 1013006931 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | 200550087NP |
Business Practice Address: | 1501 Ne Medical Center Dr Bend, OR - 977016051 |
Business Phone Number: | 5413822811 |
Business Fax Number: | |
Mailing Address: | 1501 Ne Medical Center Dr, BEND |
State: | OR |
Postal Code: | 977016051 |
Phone Number: | 5413822811 |
Fax Number: | |
NPI Enumeration Date: | 10/11/2006 |
NPI Last Update Date: | 04/15/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 200550087NP |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |