MEDICARE: COURTNEY POPPINGA CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SZ8477	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568961522
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COURTNEY POPPINGA CCC-SLP

Provider Business Mailing Address
First Line	:	603 S BRADLEY ST
Second Line	:
City	:	ROCK RAPIDS
State	:	IA
Zip	:	51246-1852
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1010 S UNION ST
Second Line	:
City	:	ROCK RAPIDS
State	:	IA
Zip	:	51246-2055
Country	:	US
Telephone Number	:	712-472-3748
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2018
Last Update Date	:	02/24/2020

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Directions to “ COURTNEY POPPINGA CCC-SLP” Practice Location

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