Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Autumn Rose Koppenhaver, CRNP

Individual provider Nurse Practitioner · NPI 1457243321

Autumn Rose Koppenhaver, CRNP is a Nurse Practitioner in Elizabethville, Pennsylvania. Qualified in 2025, 1 year ago. Practices with Family Practice Center PC, a 347-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
1
Licensed in
PA
In the registry since
2025
What do these letters mean?
CRNP — Certified Registered Nurse Practitioner
The title Pennsylvania and some other states use for a nurse practitioner.

See every abbreviation used in this directory →

Practice location Address checks out

4897 State Route 209
Elizabethville, PA 17023-8455
Phone: (717) 362-3371
Fax: (717) 362-4278
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence SP033234 (PA)

Record details

NPI number1457243321
Entity typeIndividual (Type 1)
GenderFemale
Credentials CRNP
Sole proprietorYes
NPI enumeratedJuly 16, 2025
Last updated in NPPESAugust 4, 2025
Certification dateAugust 4, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Family Practice Center Pc — 347 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Elizabethville