Provider Demographics
NPI:1972846327
Name:POPROCKI, DEBRAH ANN
Entity Type:Individual
Prefix:MS
First Name:DEBRAH
Middle Name:ANN
Last Name:POPROCKI
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:DEBRAH
Other - Middle Name:ANN
Other - Last Name:LOONEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:536 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:OH
Mailing Address - Zip Code:44001-2409
Mailing Address - Country:US
Mailing Address - Phone:440-371-3083
Mailing Address - Fax:
Practice Address - Street 1:536 JACKSON ST
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:OH
Practice Address - Zip Code:44001-2409
Practice Address - Country:US
Practice Address - Phone:440-371-3083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-04
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0059155Medicaid