Healthcare Provider Details

I. General information

NPI: 1225498751
Provider Name (Legal Business Name): WHITNEY ALAINE ROPP RN, BSN, CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2016
Last Update Date: 12/22/2021
Certification Date: 12/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 E LAKE SHORE DR
DECATUR IL
62521-3810
US

IV. Provider business mailing address

3310 S TAYLOR RD
DECATUR IL
62521-9018
US

V. Phone/Fax

Practice location:
  • Phone: 217-464-2966
  • Fax:
Mailing address:
  • Phone: 812-361-3060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number209013902
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: