Physician Compare National (NPI:1124465588)

HEALTHCARE PROVIDER: BIANCA RAE POPE FNP

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1124465588
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6406085950
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20140204001164
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	POPE
	Individual professional last name
Provider First Name	BIANCA
	Individual professional first name
Provider Middle Name	NP
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2013
	Individual professional's medical school graduation year
Primary Specialty	NURSE PRACTITIONER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	3010 ALTAMA AVE
	Group Practice or individual's line 1 address
City	BRUNSWICK
	Group Practice or individual's city
State	GA
	Group Practice or individual's state
Zip Code	315204607
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	110025
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SOUTHEAST GEORGIA HEALTH SYSTEM- BRUNSWICK CAMPUS
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y