Provider Demographics
NPI:1033656293
Name:POPE, NANCY JEAN (MSOT OTR/L)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:JEAN
Last Name:POPE
Suffix:
Gender:F
Credentials:MSOT OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 NARRAGANSETT PKWY
Mailing Address - Street 2:EF-2
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02888-4546
Mailing Address - Country:US
Mailing Address - Phone:401-368-9295
Mailing Address - Fax:
Practice Address - Street 1:1139 MAIN AVE
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-1940
Practice Address - Country:US
Practice Address - Phone:401-739-6600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-26
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIOT01094225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist