MEDICARE: MRS. TERRI L POPOVITZ DNP, APRN, PMHNP-BC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN.CNP.0035312	OH

General Provider Information

NPI Number	:	1619741329
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TERRI L POPOVITZ DNP, APRN, PMHNP-BC

Provider Business Mailing Address
First Line	:	1207 SPRINGFIELD PIKE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45215-2123
Country	:	US
Telephone Number	:	513-791-7760
Fax Number	:	513-791-7764

Provider Business Practice Location Address
First Line	:	1207 SPRINGFIELD PIKE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45215-2123
Country	:	US
Telephone Number	:	513-791-7760
Fax Number	:	513-791-7764

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

Provider Enumeration Date	:	11/13/2023
Last Update Date	:	11/13/2023

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