Provider Demographics
NPI:1013512508
Name:ROOP, BEVERLY LYNN
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:LYNN
Last Name:ROOP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 JODIE RD
Mailing Address - Street 2:
Mailing Address - City:JODIE
Mailing Address - State:WV
Mailing Address - Zip Code:26690-7714
Mailing Address - Country:US
Mailing Address - Phone:304-632-1827
Mailing Address - Fax:304-471-2488
Practice Address - Street 1:1799 MAIN ST E
Practice Address - Street 2:
Practice Address - City:OAK HILL
Practice Address - State:WV
Practice Address - Zip Code:25901-2341
Practice Address - Country:US
Practice Address - Phone:304-465-0885
Practice Address - Fax:304-465-0886
Is Sole Proprietor?:No
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker