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General NPI Number Information
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NPI Number | 1679442172
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Entity Type | Individual
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Provider Name | NICOLE ANN ROPER
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Gender | Female
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Dates
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Enumeration Date | 11/03/2025
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | 100 N MAIN ST
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City | HARRISBURG
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State | AR
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Zip | 72432-1930
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Country | US
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Telephone | 870-926-0117
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Fax |
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Provider Business Mailing Address
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Address Line | 16515 STATE HIGHWAY 25
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City | DEXTER
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State | MO
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Zip | 63841-9705
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Country | US
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Telephone | 573-421-8302
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OTR4162
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License Number State | AR
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