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General NPI Number Information
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NPI Number | 1568827947
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Entity Type | Individual
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Provider Name | GLEN ROBERT DOPP JR. DNP, APRN, FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 12/29/2015
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Last Update Date | 03/02/2025
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Provider Practice Location Address
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Address Line | 1901 RED ROCK DR
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City | GALLUP
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State | NM
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Zip | 87301-5683
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Country | US
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Telephone | 505-863-7000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 521
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City | DEER RIVER
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State | MN
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Zip | 56636-0521
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Country | US
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Telephone | 218-301-9265
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R-229298-4
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | R-229298-4
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | R-229298-4
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License Number State | MN
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Taxonomy #4
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Taxonomy Code | 163WM0102X
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Taxonomy Name | Maternal Newborn Registered Nurse
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License Number | R-229298-4
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License Number State | MN
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Taxonomy #5
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Taxonomy Code | 163WN0003X
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Taxonomy Name | Low-Risk Neonatal Registered Nurse
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License Number | R-229298-4
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License Number State | MN
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Taxonomy #6
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Taxonomy Code | 163WP0200X
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Taxonomy Name | Pediatric Registered Nurse
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License Number | R-229298-4
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License Number State | MN
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Taxonomy #7
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Taxonomy Code | 163WW0101X
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Taxonomy Name | Ambulatory Women's Health Care Registered Nurse
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License Number | R-229298-4
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License Number State | MN
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Taxonomy #8
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Taxonomy Code | 163WX0002X
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Taxonomy Name | High-Risk Obstetric Registered Nurse
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License Number | R-229298-4
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License Number State | MN
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Taxonomy #9
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 6398
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License Number State | MN
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Taxonomy #10
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 77859
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License Number State | NM
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