VICKIE ELLEN ROTHROCK PNP NPI 1982619482

NPI Information

NPI: 1982619482
Provider Name: VICKIE ELLEN ROTHROCK, PNP
Classification: Nurse Practitioner - 363LP0200X
Entity Type: Individual

Specialization: Pediatrics

Address:
3181 SW SAM JACKSON PARK RD
PORTLAND, OR
ZIP 97239
Phone: (503) 418-5710
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Vickie Ellen Rothrock, PNP is a pediatrics nurse practitioner in Portland, OR. Vickie Ellen Rothrock, PNP NPI is 1982619482. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3181 SW SAM JACKSON PARK RD
PORTLAND, OR
ZIP 97239-011
Phone: (503) 418-5710

The enumeration date for this NPI number is 7/31/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0200X	Nurse Practitioner	Pediatrics	082010299N2	OREGON	Yes
2	363LP0200X	Nurse Practitioner	Pediatrics		OREGON	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	S98101	MEDICARE UPIN
2	276684	MEDICAID	OREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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