=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447563523
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SHARON M POPE RD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/19/2010
-----------------------------------------------------
Last Update Date | 07/19/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 175 S UNION BLVD MEMORIAL HEALTH SYSTEM DISEASE AND WELLNESS OFFICE
-----------------------------------------------------
City | COLORADO SPRINGS
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80910-3113
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 719-365-5738
-----------------------------------------------------
Fax | 719-365-9519
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1400 E BOULDER ST MEMORIAL HEALTH SYSTEM NUTRITION SERVICES -SODEXO
-----------------------------------------------------
City | COLORADO SPRINGS
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80909-5533
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 719-365-5738
-----------------------------------------------------
Fax | 719-365-9519
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 133V00000X
-----------------------------------------------------
Taxonomy Name | Registered Dietitian
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------