Provider Demographics
NPI:1578342101
Name:POPE, KAYLEE (PA)
Entity Type:Individual
Prefix:
First Name:KAYLEE
Middle Name:
Last Name:POPE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:KAYLEE
Other - Middle Name:
Other - Last Name:POPE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA
Mailing Address - Street 1:3 ELIZABETH LN
Mailing Address - Street 2:
Mailing Address - City:RYE
Mailing Address - State:NH
Mailing Address - Zip Code:03870-2126
Mailing Address - Country:US
Mailing Address - Phone:603-969-9245
Mailing Address - Fax:
Practice Address - Street 1:3 ELIZABETH LN
Practice Address - Street 2:
Practice Address - City:RYE
Practice Address - State:NH
Practice Address - Zip Code:03870-2126
Practice Address - Country:US
Practice Address - Phone:603-969-9804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant