Provider Demographics
NPI:1730118985
Name:RUOPP, JOSHUA D (CRNA)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:D
Last Name:RUOPP
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 S FRONT ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17101-2010
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:111 S FRONT ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17101-2010
Practice Address - Country:US
Practice Address - Phone:717-782-5118
Practice Address - Fax:717-782-5854
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN304288L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP00365021OtherRAILROAD MEDICARE
PAS75554OtherHEALTHAMERICA
PA550126OtherHIGHMARK BLUE SHIELD
PA50063418OtherCAPITAL BLUE CROSS
PARN304288LOtherLICENSE
PARN304288LOtherLICENSE