Autumn Rose Koppenhaver, CRNP is a
Nurse Practitioner based in Elizabethville, Pennsylvania. Autumn Rose Koppenhaver is licensed to practice in Pennsylvania (license number SP033234) and her current practice location is
4897 State Route 209, Elizabethville, Pennsylvania. She can be reached at her office (for appointments etc.) via phone at
(717) 362-3371.
NPI number for Autumn Rose Koppenhaver is 1457243321 and her current mailing address is 7 Dock Hill Rd, Middleburg, Pennsylvania. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1457243321.
Provider's Profile
Full Name | Autumn Rose Koppenhaver |
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Gender | Female |
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Speciality | Nurse Practitioner |
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Location | 4897 State Route 209, Elizabethville, Pennsylvania |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1457243321
- Provider Enumeration Date: 07/16/2025
- Last Update Date: 08/04/2025
Medical Identifiers
Medical identifiers for Autumn Rose Koppenhaver such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1457243321 | NPI | - | NPPES |
1045211160001 | Medicaid | PA | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363L00000X | Nurse Practitioner | SP033234 (Pennsylvania) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Autumn Rose Koppenhaver is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Autumn Rose Koppenhaver, CRNP 7 Dock Hill Rd, Middleburg, PA 17842-8910 Ph: (570) 837-2123 | Autumn Rose Koppenhaver, CRNP 4897 State Route 209, Elizabethville, PA 17023-8455 Ph: (717) 362-3371 |
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