Provider Demographics
NPI:1881080521
Name:POPOVICH, ROCHELLE (NP-C)
Entity type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:
Last Name:POPOVICH
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 18TH ST STE 311
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101-3235
Mailing Address - Country:US
Mailing Address - Phone:304-424-4645
Mailing Address - Fax:304-424-4646
Practice Address - Street 1:600 18TH ST STE 311
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-3235
Practice Address - Country:US
Practice Address - Phone:304-424-4645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-09
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAPRN86742-NP-C363LA2200X
OHAPRN.CNP.024211363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health