MEDICARE: MRS. MERIDETH BECK POPE FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	24176742	VA

General Provider Information

NPI Number	:	1457822744
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MERIDETH BECK POPE FNP-BC

Provider Business Mailing Address
First Line	:	9530 24TH BAY ST
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23518-1714
Country	:	US
Telephone Number	:	508-380-4396
Fax Number	:

Provider Business Practice Location Address
First Line	:	9530 24TH BAY ST
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23518-1714
Country	:	US
Telephone Number	:	508-380-4396
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/11/2018
Last Update Date	:	12/11/2018

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