1992194021 NPI number — MS. CHRISTINE THOMAS ROPER FNP

Table of content: MS. CHRISTINE THOMAS ROPER FNP (NPI 1992194021)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992194021 NPI number — MS. CHRISTINE THOMAS ROPER FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROPER
Provider First Name:
CHRISTINE
Provider Middle Name:
THOMAS
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ROPER
Provider Other First Name:
CHRISTINE
Provider Other Middle Name:
LYNN
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
FNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1992194021
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2620 ELM HILL PIKE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NASHVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37214-3108
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-425-4211
Provider Business Mailing Address Fax Number:
615-425-4268

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12 BIA 120
Provider Second Line Business Practice Location Address:
PO BOX 310
Provider Business Practice Location Address City Name:
PINE HILL
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87357-0310
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-775-3271
Provider Business Practice Location Address Fax Number:
706-387-7638
Provider Enumeration Date:
01/13/2015

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: 363LF0000X , with the licence number:  184167 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363LG0600X , with the licence number: 184167 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 87984083 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".




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