Provider Demographics
NPI:1477002335
Name:POPP, KASSIE (APRN)
Entity Type:Individual
Prefix:
First Name:KASSIE
Middle Name:
Last Name:POPP
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:835 SCOTTS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:VERSAILLES
Mailing Address - State:KY
Mailing Address - Zip Code:40383-9024
Mailing Address - Country:US
Mailing Address - Phone:859-753-7182
Mailing Address - Fax:859-971-4604
Practice Address - Street 1:1725 HARRODSBURG RD STE 210
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3601
Practice Address - Country:US
Practice Address - Phone:859-977-9511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-03
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3090102363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner