Provider Demographics
NPI:1053202143
Name:POPP, DEBRA
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:POPP
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8
Mailing Address - Street 2:
Mailing Address - City:NEMOURS
Mailing Address - State:WV
Mailing Address - Zip Code:24738-0008
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6667 FALLS MILLS
Practice Address - Street 2:RTE. 102
Practice Address - City:NEMOURS
Practice Address - State:WV
Practice Address - Zip Code:24738
Practice Address - Country:US
Practice Address - Phone:304-800-4166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-15
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide