Healthcare Provider Details

I. General information

NPI: 1588614622
Provider Name (Legal Business Name): SHEILA YVONNE POPE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 11/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 S 2ND ST
MONROE LA
71202-2112
US

IV. Provider business mailing address

PO BOX 7495
MONROE LA
71211-7495
US

V. Phone/Fax

Practice location:
  • Phone: 318-651-9914
  • Fax:
Mailing address:
  • Phone: 770-596-0306
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP04791
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: