Provider Demographics
NPI:1780317198
Name:KLOPP, CAROLINE ROSE (PA-C)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:ROSE
Last Name:KLOPP
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5525 MARIE AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45248-3200
Mailing Address - Country:US
Mailing Address - Phone:513-981-5463
Mailing Address - Fax:
Practice Address - Street 1:5525 MARIE AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45248-3200
Practice Address - Country:US
Practice Address - Phone:513-981-5463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-04
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.007603RX207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine