Healthcare Provider Details

I. General information

NPI: 1295470565
Provider Name (Legal Business Name): ALEXIS ANDRESS POPE DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2022
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 WESTSHORE DR STE 102
CUMMING GA
30041-9277
US

IV. Provider business mailing address

5930 PILGRIM POINT EXT
CUMMING GA
30041-9050
US

V. Phone/Fax

Practice location:
  • Phone: 770-376-4342
  • Fax:
Mailing address:
  • Phone: 770-598-6625
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN266961
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: