Healthcare Provider Details

I. General information

NPI: 1740475771
Provider Name (Legal Business Name): RONDA POPPLEWELL NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2007
Last Update Date: 08/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7735 YANKEE RD. STE 101
WEST CHESTER OH
45044
US

IV. Provider business mailing address

4600 MONTGOMERY RD STE 105
CINCINNATI OH
45212-2697
US

V. Phone/Fax

Practice location:
  • Phone: 513-779-6700
  • Fax: 513-779-6765
Mailing address:
  • Phone: 513-487-5305
  • Fax: 513-487-5317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number09565-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: