Provider Demographics
NPI:1114341831
Name:KROPP, RICHARD (RN)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:KROPP
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27105 PLEASANT DR
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48088-6068
Mailing Address - Country:US
Mailing Address - Phone:586-298-4068
Mailing Address - Fax:
Practice Address - Street 1:45964 BRENTWOOD ST
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48042-5410
Practice Address - Country:US
Practice Address - Phone:586-948-0665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-17
Last Update Date:2014-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704273384163W00000X, 163WH1000X, 163WP0808X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WH1000XNursing Service ProvidersRegistered NurseHospice
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No251S00000XAgenciesCommunity/Behavioral Health