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General NPI Number Information
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NPI Number | 1790585040
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Entity Type | Individual
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Provider Name | ALEXANDRA G ROOP
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Gender | Female
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Dates
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Enumeration Date | 03/17/2025
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 900 VIRGINIA ST E
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City | CHARLESTON
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State | WV
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Zip | 25301-2835
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Country | US
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Telephone | 681-313-4759
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Fax |
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Provider Business Mailing Address
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Address Line | 315 25TH ST
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City | DUNBAR
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State | WV
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Zip | 25064-2205
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Country | US
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Telephone | 304-421-2880
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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 | 121714
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License Number State | WV
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