Provider Demographics
NPI:1033834411
Name:POPE, BAILEE ELIZABETH (APRN)
Entity Type:Individual
Prefix:
First Name:BAILEE
Middle Name:ELIZABETH
Last Name:POPE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:BAILEE
Other - Middle Name:ELIZABETH
Other - Last Name:CORRERO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 936
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40743-0936
Mailing Address - Country:US
Mailing Address - Phone:502-350-5700
Mailing Address - Fax:
Practice Address - Street 1:4359 NEW SHEPHERDSVILLE RD UNIT 100
Practice Address - Street 2:
Practice Address - City:BARDSTOWN
Practice Address - State:KY
Practice Address - Zip Code:40004-8002
Practice Address - Country:US
Practice Address - Phone:502-350-5700
Practice Address - Fax:502-350-5701
Is Sole Proprietor?:No
Enumeration Date:2022-10-07
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1159018163W00000X
KY3018554363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse