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General NPI Number Information
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NPI Number | 1285458950
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Entity Type | Individual
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Provider Name | JADE ROPER APRN, CNS
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Gender | Female
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Dates
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Enumeration Date | 11/11/2024
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 800 MEDICAL CENTER DR
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City | FAIRMONT
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State | MN
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Zip | 56031-4575
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Country | US
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Telephone | 507-238-5153
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Fax |
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Provider Business Mailing Address
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Address Line | 918 UPPER VALLEY DR
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City | BLUE EARTH
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State | MN
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Zip | 56013-1708
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SP0200X
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Taxonomy Name | Pediatric Clinical Nurse Specialist
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License Number | 325
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License Number State | MN
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