Provider Demographics
NPI:1548477250
Name:POPE, ILSE (FNP)
Entity type:Individual
Prefix:
First Name:ILSE
Middle Name:
Last Name:POPE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:271 NORTH L STREET
Mailing Address - Street 2:
Mailing Address - City:DINUBA
Mailing Address - State:CA
Mailing Address - Zip Code:93618-2107
Mailing Address - Country:US
Mailing Address - Phone:559-591-1820
Mailing Address - Fax:559-591-8225
Practice Address - Street 1:271 NORTH L STREET
Practice Address - Street 2:
Practice Address - City:DINUBA
Practice Address - State:CA
Practice Address - Zip Code:93618-2107
Practice Address - Country:US
Practice Address - Phone:559-591-1820
Practice Address - Fax:559-591-8225
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN221682363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily