Provider Demographics
NPI:1407020811
Name:POPE, BARBARA JEAN (LPN)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:JEAN
Last Name:POPE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1117 HOLCOMB ST
Mailing Address - Street 2:#2
Mailing Address - City:WATERTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13601
Mailing Address - Country:US
Mailing Address - Phone:315-408-6529
Mailing Address - Fax:
Practice Address - Street 1:1117 HOLCOMB ST
Practice Address - Street 2:#2
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601-4262
Practice Address - Country:US
Practice Address - Phone:315-408-6529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-16
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY292789-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse