Provider Demographics
NPI:1396025912
Name:KOPF, ROBERT SCOTT (DNP, ACNP)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:SCOTT
Last Name:KOPF
Suffix:
Gender:M
Credentials:DNP, ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 55310
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35255-5310
Mailing Address - Country:US
Mailing Address - Phone:205-731-9701
Mailing Address - Fax:
Practice Address - Street 1:1530 3RD AVE. SOUTH
Practice Address - Street 2:THT 422
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35294-0006
Practice Address - Country:US
Practice Address - Phone:205-934-3411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-26
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-111891363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL132686Medicaid
AL132688Medicaid
MS05422701Medicaid
ALZ50028OtherVIVA
AL051120381OtherBCBS
AL051120380OtherBCBS
ALZ50028OtherVIVA