EVAN ROUBAL
NPI 1043571904
Military Health Care Provider - Independent Duty Corpsman in Champlin, MN

Active since June 06, 2012
12054 MISSISSIPPI DR N, CHAMPLIN, MN 55316(760) 725-5298 Get Directions Write a Review

NPPES record last updated: June 6, 2012. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Evan Roubal NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EVAN ROUBAL (NPI 1043571904) is an individual independent duty corpsman provider in Champlin, Minnesota and active in the NPI registry since June 2012.

NPPES Registry Identity

NPI1043571904
Entity TypeIndividualMale
Primary Taxonomy1710I1002X
Provider Legal NameEVAN ROUBAL
Location Address12054 MISSISSIPPI DR NChamplin, MN 55316-2110
Mailing Address12054 Mississippi DriveChamplin, MN 55316 · (760) 725-5298
Sole ProprietorNo
Enumeration DateJune 6, 2012
NPI 1043571904 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyMilitary Health Care Provider · Independent Duty CorpsmanOther Service Providers
Taxonomy Code1710I1002X
Definition

A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals.

12054 MISSISSIPPI DR N, Champlin, MN 55316

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1043571904, enumerated as an "individual" on June 06, 2012.

The provider is located at 12054 MISSISSIPPI DR N CHAMPLIN, MN 55316 and the phone number is (760) 725-5298.

Military Health Care Provider with taxonomy code 1710I1002X and a focus in Independent Duty Corpsman.