Healthcare Provider Details

I. General information

NPI: 1538476163
Provider Name (Legal Business Name): VIRGINIA E ROPER PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DR. VIRGINIA E FERENT

II. Dates (important events)

Enumeration Date: 09/02/2010
Last Update Date: 07/01/2022
Certification Date: 07/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 CHESTNUT ST
DOVER NH
03820-3672
US

IV. Provider business mailing address

50 CHESTNUT ST
DOVER NH
03820-3672
US

V. Phone/Fax

Practice location:
  • Phone: 603-516-9300
  • Fax:
Mailing address:
  • Phone: 603-516-9300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number077293-23
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number019755
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: