Provider Demographics
NPI:1588614622
Name:POPE, SHEILA YVONNE (NP)
Entity Type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:YVONNE
Last Name:POPE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7495
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71211-7495
Mailing Address - Country:US
Mailing Address - Phone:770-596-0306
Mailing Address - Fax:
Practice Address - Street 1:850 S 2ND ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71202-2112
Practice Address - Country:US
Practice Address - Phone:318-651-9914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP04791363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1529265Medicaid
LA1529265Medicaid