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General NPI Number Information
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NPI Number | 1801171640
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Entity Type | Individual
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Provider Name | SANDRA FAYE POPPLEWELL NP
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Gender | Female
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Dates
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Enumeration Date | 10/12/2011
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Last Update Date | 11/06/2011
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Provider Practice Location Address
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Address Line | 199 HOSPITAL DR SUITE 5
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City | GALAX
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State | VA
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Zip | 24333-2454
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Country | US
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Telephone | 540-236-6136
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Fax | 540-236-2536
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Provider Business Mailing Address
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Address Line | 199 HOSPITAL DR SUITE 5
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City | GALAX
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State | VA
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Zip | 24333-2454
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Country | US
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Telephone | 540-236-6136
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Fax | 540-236-2536
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024169717
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3007021
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License Number State | KY
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