Provider Demographics
NPI:1023418183
Name:ROYCE, HOPE E (NP)
Entity type:Individual
Prefix:
First Name:HOPE
Middle Name:E
Last Name:ROYCE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:HOPE
Other - Middle Name:E
Other - Last Name:WEHRLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:PO BOX 2526
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46801-2526
Mailing Address - Country:US
Mailing Address - Phone:260-436-8686
Mailing Address - Fax:260-436-8585
Practice Address - Street 1:7601 W JEFFERSON BLVD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46804-4133
Practice Address - Country:US
Practice Address - Phone:260-436-8686
Practice Address - Fax:260-459-0036
Is Sole Proprietor?:No
Enumeration Date:2014-08-26
Last Update Date:2017-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71005117A363LF0000X, 363LF0000X
IN28199427A163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000893850OtherANTHEM
IN201254060Medicaid
IN132560013Medicare PIN
IN000000893850OtherANTHEM