Provider Demographics
NPI:1598280836
Name:KOPELMAN, ANA VERONICA S (PA-C)
Entity type:Individual
Prefix:
First Name:ANA VERONICA
Middle Name:S
Last Name:KOPELMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ANA
Other - Middle Name:J
Other - Last Name:SALVADOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10301 DEMOCRACY LN STE 203
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-2545
Mailing Address - Country:US
Mailing Address - Phone:571-407-7816
Mailing Address - Fax:703-223-5042
Practice Address - Street 1:10301 DEMOCRACY LN STE 203
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-2545
Practice Address - Country:US
Practice Address - Phone:571-407-7816
Practice Address - Fax:703-223-5042
Is Sole Proprietor?:No
Enumeration Date:2017-08-08
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA12815363A00000X
VA0110009171363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX402362402OtherCSHCN
VA1598280836Medicaid
VA30017619460001Medicaid
TX402362401Medicaid